ArticleWorld journal of critical care medicine2025
Driving pressure in acute respiratory distress syndrome for developing a protective lung strategy: A systematic review.
Article in World journal of critical care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Assessment of mortality risk by respiratory rate-specific quartiles in mechanically ventilated patients with acute respiratory distress syndrome in Mexico.Internal and emergency medicine · 2026Observational
- Driving Down Mortality: A 12-Year Retrospective Cohort Analysis of Mechanical Power and Driving Pressure in Ventilated ICU Patients.Medicina (Kaunas, Lithuania) · 2025Article
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Authors and funding
12 authors.
Funding
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Abstract
backgroundAcute respiratory distress syndrome (ARDS) is a critical condition characterized by acute hypoxemia, non-cardiogenic pulmonary edema, and decreased lung compliance. The Berlin definition, updated in 2012, classifies ARDS severity based on the partial pressure of arterial oxygen/fractional inspired oxygen fraction ratio. Despite various treatment strategies, ARDS remains a significant public health concern with high mortality rates.
aimTo evaluate the implications of driving pressure (DP) in ARDS management and its potential as a protective lung strategy.
methodsWe conducted a systematic review using databases including EbscoHost, MEDLINE, CINAHL, PubMed, and Google Scholar. The search was limited to articles published between January 2015 and September 2024. Twenty-three peer-reviewed articles were selected based on inclusion criteria focusing on adult ARDS patients undergoing mechanical ventilation and DP strategies. The literature review was conducted and reported according to PRISMA 2020 guidelines.
resultsDP, the difference between plateau pressure and positive end-expiratory pressure, is crucial in ARDS management. Studies indicate that lower DP levels are significantly associated with improved survival rates in ARDS patients. DP is a better predictor of mortality than tidal volume or positive end-expiratory pressure alone. Adjusting DP by optimizing lung compliance and minimizing overdistension and collapse can reduce ventilator-induced lung injury.
conclusionDP is a valuable parameter in ARDS management, offering a more precise measure of lung stress and strain than traditional metrics. Implementing DP as a threshold for safety can enhance protective ventilation strategies, potentially reducing mortality in ARDS patients. Further research is needed to refine DP measurement techniques and validate its clinical application in diverse patient populations.
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