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.
CITATION STYLE
Borges, J. B., Hedenstierna, G., Larsson, A., & Suarez-Sipmann, F. (2015). Altering the mechanical scenario to decrease the driving pressure. Critical Care. BioMed Central Ltd. https://doi.org/10.1186/s13054-015-1063-x
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