To verify whether the transpulmonary pressure-guided mechanical ventilation strategy can reduce right ventricular involvement, especially the incidence of acute cor pulmonale (ACP), in patients with moderate to severe ARDS induced by pneumonia compared with the currently widely used right ventricular protective mechanical ventilation strategy.
Age ≥ 18 years old
ARDS caused by pneumonia (New Global Definition of ARDS)
PaO2/FiO2≤200mmHg
Received invasive mechanical ventilation
Invasive mechanical ventilation duration > 48 hours
History of pulmonary hypertension caused by various reasons
Severe arrhythmia
BMI>30kg/m2