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Review
. 2020 Jun;132(6):1569-1576.
doi: 10.1097/ALN.0000000000003195.

Driving Pressure for Ventilation of Patients with Acute Respiratory Distress Syndrome

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Review

Driving Pressure for Ventilation of Patients with Acute Respiratory Distress Syndrome

Angela Meier et al. Anesthesiology. 2020 Jun.
No abstract available

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Conflict of interest statement

Competing Interests

Dr. Meier reports receiving an International Anesthesia Research Society (San Francisco, California) Mentored Training Grant and the Altman Clinical and Translational Research Institute (La Jolla, California) Pilot Grant outside of the submitted work, as well as a speaker fee from the California Society of Anesthesiologists (Sacramento, California), and reviews grants for the International Anesthesia Research Society. The other authors declare no competing interests.

Figures

Fig. 1.
Fig. 1.
A schematic diagram of an inspiratory waveform delivered during typical volume cycled ventilation. Pplat is based on an end-inspiratory hold. The driving pressure can be seen as the difference between the Pplat and the PEEP, but can also be calculated as the ratio of the VT to the respiratory system compliance. PEEP, positive end-expiratory pressure; PIP, peak inspiratory pressure; Pplat, plateau pressure; VT, tidal volume.
Fig. 2.
Fig. 2.
The impact of reduced driving pressure depends greatly on how it is achieved and on the underlying biology of the lung. The figure illustrates the varying results that could occur with reduced driving pressure, emphasizing the need to avoid assessing variables in isolation and to assess individual patients at the bedside after any mechanical ventilator changes. PEEP, positive end-expiratory pressure; VT, tidal volume.

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