13 November 2024
Predicting outcomes in ARDS patients ‑ Does partitioning respiratory mechanics help?
1. Optimizing ventilatory strategies to minimize ventilator‑induced lung injury (VILI) is crucial for improving patient outcomes in acute respiratory distress syndrome (ARDS).
2. Airway driving pressure has been found to show a strong association with outcomes in ventilated patients
3. VILI is linked to lung stretch, and transpulmonary driving pressure (∆PL) or tidal lung stress may be more accurate determinants of VILI than ∆Paw by eliminating the chest wall contribution to ∆Paw.
4. Calculated indices relating to transpulmonary pressures, particularly in the dorsal and ventral lung regions, may have varying implications for monitoring VILI.
5. Main study hypothesis: ∆PL is a superior predictor of outcome compared to ∆Paw.
6. Secondary hypothesis: The oxygenation stretch index, which is a composite variable using PaO2/FiO2 divided by ∆Paw, can enhance the predictive power of ∆Paw.
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