3. Lapinski, et al13 studied the safety and efficacy of the SI maneuver in 14 adults with ARDS. The pressure utilized in the maneuver was the lesser of 45 cm H2O or the plateau pressure utilized in 12 mL/kg tidal volume breaths; the maneuver was held for 20 seconds. Oxygen saturations increased from 86.9 ± 5.5 to 94.3 ± 2.3% by 10 minutes, which was maintained at 4 hours in 10/14 patients. The four in whom saturations fell had PEEP levels below 10 cm H2O. The systolic blood pressure decreased during the 20 second inflation in some patients, mean change of 6.9 mm Hg, which reversed rapidly following release of the maneuver in all patients. No barotrauma was noted in any patient at 24 hour followup.