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World J Crit Care Med. Mar 9, 2024; 13(1): 88385
Published online Mar 9, 2024. doi: 10.5492/wjccm.v13.i1.88385
Driving pressure in mechanical ventilation: A review
Syeda Farheen Zaidi, Asim Shaikh, Daniyal Aziz Khan, Salim Surani, Iqbal Ratnani
Syeda Farheen Zaidi, Department of Medicine, Queen Mary University, London E1 4NS, United Kingdom
Asim Shaikh, Department of Medicine, Aga Khan University, Sindh, Karachi 74500, Pakistan
Daniyal Aziz Khan, Department of Medicine, Jinnah Postgraduate Medical Center, Sindh, Karachi 75510, Pakistan
Salim Surani, Department of Medicine and Pharmacology, Texas A and M University, College Station, TX 77843, United States
Iqbal Ratnani, Department of Anesthesiology and Critical Care, Houston Methodist Hospital, Houston, TX 77030, United States
Author contributions: Zaidi SF, Shaikh A, and Khan DA contributed to the literature search, writing, and review of the manuscript; Surani S and Ratnani I contributed in concept generation, review and overall supervision and editing.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salim Surani, FCCP, MD, Professor, Department of Medicine and Pharmacology, Texas A and M University, No. 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Received: September 23, 2023
Peer-review started: September 23, 2023
First decision: November 9, 2023
Revised: December 4, 2023
Accepted: January 5, 2024
Article in press: January 5, 2024
Published online: March 9, 2024
Core Tip

Core Tip: Driving pressures (∆P) of < 15 have demonstrated the greatest benefit in mortality. It is most utilized in patients with acute respiratory distress syndrome (ARDS). Some large-scale randomized controlled trials are currently underway; their results will dictate the outcomes of certain ∆Ps under specialized conditions, such as the feasibility of reducing ∆P in ARDS patients on mechanical ventilation and the impact of lateral positioning on ∆P. It is clear, however, that careful implementation of ∆Ps can greatly improve outcomes.