Clinical Research Directory

Inclusion Criteria: * Age ≥18 years * PaO2/FiO2 ratio ≤ 200; * PaCO2 \< 45 mmHg; * At least one symptom prompting the use of sedative-analgesic drugs according to the prescription of the attending physician: dyspnea and/or discomfort equal of greater than 4/10 (Visual Analog Scale - VAS), respiratory rate equal or greater than 25 breaths per minute, PaCO2\<35 mmHg, pain (Numeric Rating Scale ≥ 4 or Behavioral Pain Scale - Non-Intubated ≥ 4); * Informed consent signature. Exclusion Criteria: * Pregnancy; * Exacerbation of asthma or chronic obstructive pulmonary disease; * Chronic lung disease, requiring oxygen therapy at home; * Cardiogenic pulmonary oedema; * Hemodynamic instability (systolic blood pressure \<90 mmHg or mean arterial pressure \<65 mmHg) and/or lactic acidosis (lactate \>5 mmol/L) and/or clinically diagnosed shock; * Metabolic acidosis (pH \<7.30 with normal or hypocarbia); * Glasgow Coma Scale \<13; * Contraindications to esophageal balloon and/or EIT placement.