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VOLUME 7 , ISSUE 2 ( July-December, 2018 ) > List of Articles

REVIEW ARTICLE

Driving Pressure: Clinical Applications and Implications in the Intensive Care Units

Jithin K. Sreedharan, Jaber Saud Alqahtani

Keywords : Acute respiratory distress syndrome, driving pressure, lung injury, mechanical ventilation, ventilator.induced lung injury

Citation Information : Sreedharan JK, Alqahtani JS. Driving Pressure: Clinical Applications and Implications in the Intensive Care Units. Indian J Respir Care 2018; 7 (2):62-66.

DOI: 10.4103/ijrc.ijrc_12_18

License: CC BY-NC-SA 4.0

Published Online: 02-12-2022

Copyright Statement:  Copyright © 2018; Indian Journal of Respiratory Care.


Abstract

Acute respiratory distress syndrome (ARDS) is considered a frequent and serious lung disease that is continuously linked with an increase in both morbidity and mortality. Mechanical ventilation (MV) is considered as the gold standard therapy in the management of ARDS; although MV support is lifesaving, it is also associated with potentially harmful threats such as ventilator-induced lung injury (VILI). It is understood from the physiological background itself that VILI has a considerable impact on the prognosis of a patient. Therefore, the current studies show that focusing on key therapeutic elements causing over-distension of the available lung units is more imperative for indicating further damage than how much pressure is used to ventilate. In the past two decades, there has been an increasing trend toward using driving pressure (DP) in the management of ARDS patients in intensive care units (ICUs). Recent studies propose that measuring DP in ARDS patients, in addition to the other respiratory mechanics measurements, may support selecting and customizing appropriate ventilator parameters, which, in turn, improves patient outcomes and decreases mortality rate. Therefore, this review is intended to outline the physiological meaning of DP, the clinical measurement and application of DP and factors limiting DP. Furthermore, measuring DP in non-ARDS patients and recent clinical evidence for the use of DP in the ICUs will be discussed in detail.

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