The Future Of Driving Pressure: A Primary Goal For Mechanical Ventilation?
Driving pressure guided ventilation Protective ventilation is a prevailing ventilatory strategy these days and is comprised of small tidal volume, limited inspiratory pressure, and application of positive end-expiratory pressure (PEEP). However, several retrospective studies recently suggested that tidal volume, inspiratory pressure, Author: Hyun Joo Ahn, Mihye Park, Jie Ae Kim, Mikyung Yang, Susie Yoon, Bo Rim Kim, Jae Hyon Bahk, Young Jun.
In summary, driving pressure during mechanical ventilation is directly to stress forces in the lung. Sizing Vt in proportion to the size of the baby lung by targeting driving pressure, rather than to IBW, might better protect the lungs in patients with more severe lung injury and low end-expiratory lung volumes [8, 13].Author: Guillermo Bugedo, Jaime Retamal, Alejandro Bruhn.
The effect of driving pressures in COVID ARDS: Lower may still be better as in classic ARDS
Driving pressure, although directly measured from the ventilator, is a function of both V T and respiratory system compliance (driving pressure = V T / respiratory system compliance). Both increases in V T and decreases in respiratory system (lung, chest wall) compliance can increase driving politedriving.com: Angela Meier, Rebecca E. Sell, Atul Malhotra.
The future of driving pressure: a primary goal for mechanical ventilation?
DOI: In this prospective cohort, we aimed to assess the characteristics of the respiratory system in COVID patients under invasive mechanical ventilation and evaluate their relationship with mortality. Methods: Fifty-eight COVID patients who underwent invasive mechanical ventilation between March 11, and September 1, were enrolled for the present study. Demographics and laboratory values at baseline were recorded.
Respiratory variables such as tidal volume, plateau pressure, positive end expiratory pressure, static compliance, and driving pressure were recorded daily under passive conditions. Further, the median values were analyzed. Plateau pressure, driving pressure, and static compliance significantly differ between the survivors and non-survivors.
Lung protective ventilation with low plateau and driving pressures might be related to lower mortality. Published by Elsevier B. All rights reserved. MeSH terms.
Mechanical Ventilation in Critical Care: Why driving pressure matters