DP

Q: How Driving Pressure (DP) can easily be calculated on the ventilator?

Answer: DP is increasingly used as guiding target in patients with ARDS who requires Low Tidal Volume Ventilation (LTVV). There are two easy ways to calculate DP

plateau-pressure minus applied PEEP 

and/or

Tidal-Volume/compliance

A value less than 20 cm H2O, and preferably below 15 cm H2O is of benefit.

#ventilators

References:

1. 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. 

2. Bellani G, Grassi A, Sosio S, et al. Driving Pressure Is Associated with Outcome during Assisted Ventilation in Acute Respiratory Distress Syndrome. Anesthesiology 2019; 131:594. 

3. Villar J, Martín-Rodríguez C, Domínguez-Berrot AM, et al. A Quantile Analysis of Plateau and Driving Pressures: Effects on Mortality in Patients With Acute Respiratory Distress Syndrome Receiving Lung-Protective Ventilation. Crit Care Med 2017; 45:843. 

4. Pereira Romano ML, Maia IS, Laranjeira LN, Damiani LP, Paisani DM, Borges MC, Dantas BG, Caser EB, Victorino JA, Filho WO, Amato MBP, Cavalcanti AB. Driving Pressure-limited Strategy for Patients with Acute Respiratory Distress Syndrome. A Pilot Randomized Clinical Trial. Ann Am Thorac Soc. 2020 May;17(5):596-604. doi: 10.1513/AnnalsATS.201907-506OC. PMID: 32069068.