ArticleCritical care (London, England)2016
Airway driving pressure and lung stress in ARDS patients.
Article in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04419376 (Driving Pressure and Mortality), which is not on this map. Cited by 89 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Driving Pressure and Mortality: in the Pediatric Intensive Care Unit (PICU)
Who cites it
89 citing papers in PubMed, 3 syntheses or guidelines pooled it, 207 citations in OpenAlex.
- Driving pressure-limited ventilation strategies versus conventional lung protective ventilation strategies for patients with ARDS/ARF: a systematic review and meta-analysis of randomized controlled trials.Critical care (London, England) · 2025Pooled it
- Differential Prognostic Analysis of Higher and Lower PEEP in ARDS Patients: Systematic Review and Meta-Analysis.Journal of healthcare engineering · 2022Pooled it
- An Updated Review of Driving-Pressure Guided Ventilation Strategy and Its Clinical Application.BioMed research international · 2022Pooled it
- [Driving pressure-guided lung protective ventilation strategy reduces postoperative pulmonary complications in patients recovered from COVID-19].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2023Trial
- Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials.Critical care (London, England) · 2016Trial
- Nurse-led respiratory care bundle and pneumonia prevention in critically ill patients with abdominal sepsis: a multicenter before-and-after controlled study.Critical care (London, England) · 2026Article
- Scheduled Bronchoscopy with Nebulized Heparin and N-Acetylcysteine in Burn Patients with Inhalation Injury: A Randomized Trial.European burn journal · 2026Article
- Short-Term Physiological Effects of Moderate PEEP Levels in Invasively Ventilated Patients Without Acute or Chronic Lung Disease.Medical sciences (Basel, Switzerland) · 2026Article
- Impact of Respiratory Effort Parameters on Clinical Outcomes in Respiratory Failure Patients (Effort-I): A Prospective Observational Study.Annals of intensive care · 2026Article
- The cGAS-STING pathway in pulmonary infectious and sterile inflammation: differences, connections, and therapeutic implications.Frontiers in immunology · 2026Review
- Mechanical Power and Driving Pressure: Mechanisms of Lung Injury, Markers of Pathophysiology, or Therapeutic Targets?Journal of clinical medicine · 2025Article
- Bedside ventilatory settings guided by respiratory mechanics in acute respiratory distress syndrome.Annals of intensive care · 2025Review
- Computer model-based injury prediction and evaluation of lung function in mice with acute and ventilator-induced lung injuries.American journal of physiology. Lung cellular and molecular physiology · 2025Article
- PEEP-AKI-COVID ICU: Effect of positive end-expiratory pressure on acute kidney injury development in patients with COVID-19-associated acute respiratory distress syndrome: an ancillary analysis of the COVID-ICU study.Journal of intensive care · 2025Article
- Ventilator-Associated Lung Injury: Pathophysiology, Prevention, and Emerging Therapeutic Strategies.International journal of molecular sciences · 2025Review
- Optimizing Positive End-Expiratory Pressure in Asymmetric Acute Lung Injury in a Porcine Model: The Role of Transpulmonary Pressure.International journal of molecular sciences · 2025Article
- Brain Protective Ventilation Strategies in Severe Acute Brain Injury.Current neurology and neuroscience reports · 2025Review
- Influence of the end inspiratory pause on ventilatory efficiency and respiratory mechanics in patients undergoing robotic surgery under a tailored open lung approach: a prospective-paired study.Anaesthesiology intensive therapy · 2025Article
- Rheological Theory Applied to Mechanical Ventilation in Acute Respiratory Distress Syndrome: A New Paradigm for Understanding and Preventing Ventilator-Induced Lung Injury.Journal of clinical medicine · 2025Review
- Driving pressure in acute respiratory distress syndrome for developing a protective lung strategy: A systematic review.World journal of critical care medicine · 2025Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLung-protective ventilation strategy suggests the use of low tidal volume, depending on ideal body weight, and adequate levels of PEEP. However, reducing tidal volume according to ideal body weight does not always prevent overstress and overstrain. On the contrary, titrating mechanical ventilation on airway driving pressure, computed as airway pressure changes from PEEP to end-inspiratory plateau pressure, equivalent to the ratio between the tidal volume and compliance of respiratory system, should better reflect lung injury. However, possible changes in chest wall elastance could affect the reliability of airway driving pressure. The aim of this study was to evaluate if airway driving pressure could accurately predict lung stress (the pressure generated into the lung due to PEEP and tidal volume).
methodsOne hundred and fifty ARDS patients were enrolled. At 5 and 15 cmH2O of PEEP, lung stress, driving pressure, lung and chest wall elastance were measured.
resultsThe applied tidal volume (mL/kg of ideal body weight) was not related to lung gas volume (r (2) = 0.0005 p = 0.772). Patients were divided according to an airway driving pressure lower and equal/higher than 15 cmH2O (the lower and higher airway driving pressure groups). At both PEEP levels, the higher airway driving pressure group had a significantly higher lung stress, respiratory system and lung elastance compared to the lower airway driving pressure group. Airway driving pressure was significantly related to lung stress (r (2) = 0.581 p < 0.0001 and r (2) = 0.353 p < 0.0001 at 5 and 15 cmH2O of PEEP). For a lung stress of 24 and 26 cmH2O, the optimal cutoff value for the airway driving pressure were 15.0 cmH2O (ROC AUC 0.85, 95 % CI = 0.782-0.922); and 16.7 (ROC AUC 0.84, 95 % CI = 0.742-0.936).
conclusionsAirway driving pressure can detect lung overstress with an acceptable accuracy. However, further studies are needed to establish if these limits could be used for ventilator settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.