How I use driving pressure - Professor Marcelo Amato

The AVF Podcast: ICU Tips & Tricks invites colleagues to share anything and everything on how they deal with various clinical situations. Expect discussions on how experts personalise evidence-based medicine for the patient at the bedside.
In this episode, Professor Amato shares his thoughts on driving pressure and how he uses it to manage patients on mechanical ventilation. Professor Amato is from the Faculty of Medicine at the University of Sāo Paulo, Brazil. He is a pulmonologist and intensivist at the Pulmonary Division of the Hospital das Clínicas.
Issues discussed in this interview:
- The concept of driving pressure
- Association of driving pressure with mortality: cause or effect?
- How to measure driving pressure
- How to adjust driving pressure
- Transpulmonary driving pressure
- Driving pressure, respiratory rate, and mechanical power
Work cited:
1. Dreyfuss D, Soler P, Basset G, Saumon G. High inflation pressure pulmonary edema. Respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure. Am Rev Respir Dis 1988;137:1159-64.
2. Amato MB, Meade MO, Slutsky AS, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015;372:747-55.
3. Bertoni M, Telias I, Urner M, et al. A novel non-invasive method to detect excessively high respiratory effort and dynamic transpulmonary driving pressure during mechanical ventilation. Crit Care 2019;23:346.
4. Gattinoni L, Tonetti T, Cressoni M, et al. Ventilator-related causes of lung injury: the mechanical power. Intensive Care Med 2016;42:1567-75.
5. Costa ELV, Slutsky AS, Brochard LJ, et al. Ventilatory variables and mechanical power in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2021;204:303-11.

[@juandanielcaicedoruiz3878]

Excelent talk, so much knowledge! Thanks for the effort

[@GustavoMontanha]

great conversation - very knowledgeable from both! Loved it!

[@bga2799]

Awesome content!!

[@fatencriticalcare1352]

Good healthy

[@gabmor7779]

If constant transpulmonary pressure doesnt cause damage, aprv should be less damaging to the alveoli?

[@ronaldshiffman9171]

APRV should be eliminated from use. Conventional ventilation is much better. Why use a mode shown to be less effective?