As defined by the Berlin Definition, a patient has “severe”…

As defined by the Berlin Definition, a patient has “severe” ARDS. The patient is chemically paralyzed and sedated, plateau pressure (Pplat) is 28 cmH2O, FiO2 is 1.0, the level of PEEP is optimally set, and ventilation is not improving with low Vt/high RR ventilation. The physician asks for your recommendation in improving gas exchange. What is the most appropriate recommendation?