Effect of Positive End-Expiratory Pressure Titration on Venous Excess Ultrasound Score and Renal Outcomes in Patients With Acute Respiratory Distress Syndrome

This study is a prospective observational cohort study conducted planned to include 40 patients with ARDS to assess the effect of different levels of PEEP titration on VExUS score and renal outcomes in patients with Acute Respiratory Distress Syndrome.

This study is a prospective observational cohort study conducted planned to include 40 patients with ARDS within 24 hours of onset and mechanically ventilated for more than 24 hours to assess the effect of different levels of PEEP titration on Venous Excess Ultrasound Score and renal outcomes in patients with Acute Respiratory Distress Syndrome.

Inclusion Criteria: * Age ≥18 years. * Diagnosis of ARDS according to the Berlin criteria. * Invasive mechanical ventilation ≥24 hours. * Requirement of PEEP ≥5 cmH₂O. Exclusion Criteria: * Known end-stage renal disease on chronic dialysis. * History of renal transplantation. * Pregnancy. * Known severe tricuspid regurgitation. * Chronic liver disease with portal hypertension. * Poor ultrasound window precluding adequate venous Doppler assessment.