Bibliographic Details
| Title: |
Driving pressure-guided ventilation decreases the mechanical power compared to predicted body weight-guided ventilation in the Acute Respiratory Distress Syndrome |
| Authors: |
Anne-Fleur Haudebourg, Samuel Tuffet, François Perier, Keyvan Razazi, Nicolas de Prost, Armand Mekontso Dessap, Guillaume Carteaux |
| Source: |
Critical Care, Vol 26, Iss 1, Pp 1-9 (2022) |
| Publisher Information: |
BMC, 2022. |
| Publication Year: |
2022 |
| Collection: |
LCC:Medical emergencies. Critical care. Intensive care. First aid |
| Subject Terms: |
Acute respiratory distress syndrome, Mechanical ventilation, Protective ventilation, Tidal volume, Driving pressure, Ventilator-induced lung injury, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9 |
| More Details: |
Abstract Background Whether 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. Methods We 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 H2O. The respiratory rate was then re-adjusted within a range from 12 to 40 breaths/min until EtCO2 returned to its baseline value (∆P-guided ventilation). Mechanical power was computed at each step. Results Fifty-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 |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1364-8535 |
| Relation: |
https://doaj.org/toc/1364-8535 |
| DOI: |
10.1186/s13054-022-04054-5 |
| Access URL: |
https://doaj.org/article/87135cfe8a6c448f90bdb2513f1e8bc6 |
| Accession Number: |
edsdoj.87135cfe8a6c448f90bdb2513f1e8bc6 |
| Database: |
Directory of Open Access Journals |
