Should We Care about Driving Pressure during Assisted Mechanical Ventilation?
Journal Title: Journal of Intensive and Critical Care - Year 2017, Vol 3, Issue 2
Abstract
During passive mechanical ventilation, at absence of dynamic hyperinflation, driving pressure of respiratory system (ΔP) is defined as static end-inspiratory plateau pressure (Pplat) minus external positive end-expiratory pressure (PEEP), and equals tidal volume (VT) to respiratory system compliance (Crs) ratio. ΔP essentially reflects the extent of lung stretch during tidal breathing. Thus, ΔP may reflect better than Pplat or VT, expressed as ml/kg of ideal body weight, the alveolar distortion during inspiration because it takes into account the available aerated lung volume. Indeed, a large retrospective study in patients with acute respiratory distress syndrome (ARDS) identified ΔP as the main determinant of ventilator-induced lung injury (VILI), and the ventilator parameter most strongly related to mortality, particularly at ΔP values >14 cm H2O [1].
Authors and Affiliations
Katerina Vaporidi, Nectaria Xirouchaki, Dimitris Georgopoulos
Keywords
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- EP ID EP300729
- DOI 10.21767/2471-8505.100085
- Views 54
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