Zaidi Syeda Farheen, Shaikh Asim, Khan Daniyal Aziz, Surani Salim, Ratnani Iqbal
Department of Medicine, Queen Mary University, London E1 4NS, United Kingdom.
Department of Medicine, Aga Khan University, Sindh, Karachi 74500, Pakistan.
World J Crit Care Med. 2024 Mar 9;13(1):88385. doi: 10.5492/wjccm.v13.i1.88385.
Driving pressure (∆P) is a core therapeutic component of mechanical ventilation (MV). Varying levels of ∆P have been employed during MV depending on the type of underlying pathology and severity of injury. However, ∆P levels have also been shown to closely impact hard endpoints such as mortality. Considering this, conducting an in-depth review of ∆P as a unique, outcome-impacting therapeutic modality is extremely important. There is a need to understand the subtleties involved in making sure ∆P levels are optimized to enhance outcomes and minimize harm. We performed this narrative review to further explore the various uses of ∆P, the different parameters that can affect its use, and how outcomes vary in different patient populations at different pressure levels. To better utilize ∆P in MV-requiring patients, additional large-scale clinical studies are needed.
驱动压(∆P)是机械通气(MV)的核心治疗要素。在机械通气期间,根据潜在病理类型和损伤严重程度采用了不同水平的∆P。然而,∆P水平也已显示出对死亡率等硬性终点有密切影响。鉴于此,对∆P作为一种独特的、影响预后的治疗方式进行深入综述极为重要。有必要了解确保优化∆P水平以改善预后并将危害降至最低所涉及的细微之处。我们进行了这项叙述性综述,以进一步探讨∆P的各种用途、可能影响其使用的不同参数,以及在不同压力水平下不同患者群体的预后如何变化。为了在需要机械通气的患者中更好地利用∆P,还需要开展更多大规模临床研究。