ArticleCritical care (London, England)2022
Driving pressure-guided ventilation decreases the mechanical power compared to predicted body weight-guided ventilation in the Acute Respiratory Distress Syndrome.
Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Effect of driving pressure-guided positive end-expiratory pressure on respiratory mechanics and clinical outcomes in surgical patients: a systematic review and meta-analysis of randomized controlled trials.Annals of medicine · 2025Pooled it
- Understanding lung physiology through ventilator screen.Intensive care medicine · 2026Article
- Pulmonary vascular dysfunction in ARDS Pathophysiology and therapeutic implications.Annals of intensive care · 2026Review
- Bedside ventilatory settings guided by respiratory mechanics in acute respiratory distress syndrome.Annals of intensive care · 2025Review
- Factors influencing the transition phase in acute respiratory distress syndrome: an observational cohort study.Annals of intensive care · 2025Article
- The endothelial-immunothrombotic storm in viral sepsis: lessons from COVID-19.Frontiers in immunology · 2025Review
- Comparing the impact of targeting limited driving pressure to low tidal volume ventilation on mortality in mechanically ventilated adults with COVID-19 ARDS: an exploratory target trial emulation.BMJ open respiratory research · 2024Article
- Expert perspectives on ECCOAnnals of intensive care · 2024Article
- Driving pressure decoded: Precision strategies in adult respiratory distress syndrome management.World journal of critical care medicine · 2024Article
- Flow-controlled ventilation decreases mechanical power in postoperative ICU patients.Intensive care medicine experimental · 2024Article
- Driving pressure in mechanical ventilation: A review.World journal of critical care medicine · 2024Review
- Mechanical power and normalized mechanical power in pediatric acute respiratory distress syndrome.Frontiers in pediatrics · 2024Article
- The Impact of Mechanical Energy Assessment on Mechanical Ventilation: A Comprehensive Review and Practical Application.Medical science monitor : international medical journal of experimental and clinical research · 2023Review
- Is COVID-19 different from other causes of acute respiratory distress syndrome?Journal of intensive medicine · 2023Review
- Mechanical power of ventilation and driving pressure: two undervalued parameters for pre extracorporeal membrane oxygenation ventilation and during daily management?Critical care (London, England) · 2023Review
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhether targeting the driving pressure (∆P) when adjusting the tidal volume in mechanically ventilated patients with the acute respiratory distress syndrome (ARDS) may decrease the risk of ventilator-induced lung injury remains a matter of research. In this study, we assessed the effect of a ∆P-guided ventilation on the mechanical power.
methodsWe prospectively included adult patients with moderate-to-severe ARDS. Positive end expiratory pressure was set by the attending physician and kept constant during the study. Tidal volume was first adjusted to target 6 ml/kg of predicted body weight (PBW-guided ventilation) and subsequently modified within a range from 4 to 10 ml/kg PBW to target a ∆P between 12 and 14 cm H
resultsFifty-one patients were included between December 2019 and May 2021. ∆P-guided ventilation was feasible in all but one patient. The ∆P during PBW-guided ventilation was already within the target range of ∆P-guided ventilation in five (10%) patients, above in nine (18%) and below in 36 (72%). The change from PBW- to ∆P-guided ventilation was thus accompanied by an overall increase in tidal volume from 6.1 mL/kg PBW [5.9-6.2] to 7.7 ml/kg PBW [6.2-8.7], while respiratory rate was decreased from 29 breaths/min [26-32] to 21 breaths/min [16-28] (p < 0.001 for all comparisons). ∆P-guided ventilation was accompanied by a significant decrease in mechanical power from 31.5 J/min [28-35.7] to 28.8 J/min [24.6-32.6] (p < 0.001), representing a relative decrease of 7% [0-16]. With ∆P-guided ventilation, the PaO
conclusionAs compared to a conventional PBW-guided ventilation, a ∆P-guided ventilation strategy targeting a ∆P between 12 and 14 cm H
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