Driving Pressure Decoded: Precision Strategies in Adult Respiratory Distress Syndrome Management

Authors

Muhammad Adrish
Sai Doppalapudi
Dmitry Lvovsky

Publication Date

6-9-2024

Journal

World Journal of Critical Care Medicine

DOI

10.5492/wjccm.v13.i2.92441

PMID

38855266

PMCID

PMC11155505

PubMedCentral® Posted Date

6-9-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Driving pressure, Mechanical ventilation, Lung-protective ventilation strategies, Ventilator-induced lung injury

Abstract

Mechanical ventilation (MV) is an important strategy for improving the survival of patients with respiratory failure. However, MV is associated with aggravation of lung injury, with ventilator-induced lung injury (VILI) becoming a major concern. Thus, ventilation protection strategies have been developed to minimize complications from MV, with the goal of relieving excessive breathing workload, improving gas exchange, and minimizing VILI. By opting for lower tidal volumes, clinicians seek to strike a balance between providing adequate ventilation to support gas exchange and preventing overdistension of the alveoli, which can contribute to lung injury. Additionally, other factors play a role in optimizing lung protection during MV, including adequate positive end-expiratory pressure levels, to maintain alveolar recruitment and prevent atelectasis as well as careful consideration of plateau pressures to avoid excessive stress on the lung parenchyma.