Altering the mechanical scenario to decrease the driving pressure
2015 (English)In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 19, no 1, 342Article in journal, Letter (Refereed) Published
Ventilator settings resulting in decreased driving pressure (ΔP) are positively associated with survival. How to further foster the potential beneficial mediator effect of a reduced ΔP? One possibility is promoting the active modification of the lung's "mechanical scenario" by means of lung recruitment and positive end-expiratory pressure selection. By taking into account the individual distribution of the threshold-opening airway pressures to achieve maximal recruitment, a redistribution of the tidal volume from overdistended to newly recruited lung occurs. The resulting more homogeneous distribution of transpulmonary pressures may induce a relief of overdistension in the upper regions. The gain in lung compliance after a successful recruitment rescales the size of the functional lung, potentially allowing for a further reduction in ΔP.
Place, publisher, year, edition, pages
2015. Vol. 19, no 1, 342
Anesthesiology and Intensive Care
Research subject Anaesthesiology and Intensive Care; Physiology
IdentifiersURN: urn:nbn:se:uu:diva-264208DOI: 10.1186/s13054-015-1063-xISI: 000361435100001PubMedID: 26387728OAI: oai:DiVA.org:uu-264208DiVA: diva2:859522