End-expiratory Transpulmonary Pressure-guided vs Electrical Impedance Tomography-guided PEEP Titration Methods in Patients With Intra-abdominal Hypertension Combined With Acute Respiratory Distress Syndrome: a Randomized Crossover Controlled Study

This study is comparing two different methods for setting the breathing machine pressure in critically ill patients on a ventilator who have both high abdominal pressure and a serious lung condition called ARDS (acute respiratory distress syndrome), to see which approach improves oxygen levels more safely. **You may be eligible if...** - You are between 18 and 80 years old - You are in the ICU with increased pressure in your abdomen (12 mmHg or above) - You have been diagnosed with ARDS (a condition where the lungs cannot get enough oxygen into the blood) - Your oxygen levels are severely impaired - You have been on a breathing machine for less than 36 hours **You may NOT be eligible if...** - You are under 18 or over 80 - You have uncontrolled shock from any cause - You have pre-existing lung diseases like COPD or pulmonary fibrosis - Consent from you or your family has not been obtained Talk to your doctor to see if this trial is right for you.