Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. DeadSpace %, Shunt %, and VQMatch % were calculated based on lung EIT perfusion and ventilation images. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio 8 s). EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 cmH 2O) PEEP. The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients.
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