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Research ArticleOriginal Research

Titration of Ventilator Settings to Target Driving Pressure and Mechanical Power

Elias N Baedorf Kassis, Stephanie Hu, MingYu Lu, Alistair E W Johnson, Somnath Bose, Maximilian S Schaefer, Daniel S Talmor, Li-Wei H Lehman and Zach S Shahn
Respiratory Care February 2023, 68 (2) 199-207; DOI: https://doi.org/10.4187/respcare.10258
Elias N Baedorf Kassis
Division of Pulmonary and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
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  • For correspondence: [email protected]
Stephanie Hu
Laboratory for Computational Physiology, Massachusetts Institute of Technology, Boston, Massachusetts.
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MingYu Lu
Laboratory for Computational Physiology, Massachusetts Institute of Technology, Boston, Massachusetts.
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Alistair E W Johnson
Laboratory for Computational Physiology, Massachusetts Institute of Technology, Boston, Massachusetts.
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Somnath Bose
Department of Anesthesia, Pain and Critical Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
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Maximilian S Schaefer
Department of Anesthesia, Pain and Critical Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
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Daniel S Talmor
Department of Anesthesia, Pain and Critical Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
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Li-Wei H Lehman
Laboratory for Computational Physiology, Massachusetts Institute of Technology, Boston, Massachusetts; and MIT-IBM Watson AI Lab, Cambridge, Massachusetts.
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Zach S Shahn
Department of Epidemiology and Biostatistics, CUNY School of Public Health, New York City, New York; and IBM Research, Yorktown Heights, New York.
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REFERENCES

  1. 1.↵
    1. Nieman GF,
    2. Gatto LA,
    3. Habashi NM
    . Impact of mechanical ventilation on the pathophysiology of progressive acute lung injury. J Appl Physiol (1985) 2015;119(11):1245-1261.
    OpenUrlCrossRefPubMed
  2. 2.
    1. Gattinoni L,
    2. Pesenti A
    . The concept of “baby lung.” Intensive Care Med 2005;31(6):776-784.
    OpenUrlCrossRefPubMedWeb of Science
  3. 3.
    1. Gattinoni L,
    2. Tonetti T,
    3. Quintel M
    . Regional physiology of ARDS. Crit Care 2017;21(Suppl 3):312.
    OpenUrl
  4. 4.↵
    1. Beitler JR,
    2. Malhotra A,
    3. Thompson BT
    . Ventilator-induced lung injury. Clin Chest Med 2016;37(4):633-646.
    OpenUrlCrossRef
  5. 5.↵
    1. Grasso S,
    2. Stripoli T,
    3. De Michele M,
    4. Bruno F,
    5. Moschetta M,
    6. Angelelli G,
    7. et al
    . ARDSnet ventilatory protocol and alveolar hyperinflation. Am J Respir Crit Care Med 2007;176(8):761-767.
    OpenUrlCrossRefPubMedWeb of Science
  6. 6.↵
    1. Briel M,
    2. Meade M,
    3. Mercat A,
    4. Brower RG,
    5. Talmor D,
    6. Walter SD,
    7. et al
    . Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 2010;303(9):865-873.
    OpenUrlCrossRefPubMedWeb of Science
  7. 7.↵
    1. Brower RG,
    2. Matthay MA,
    3. Morris A,
    4. Schoenfeld D,
    5. Thompson BT,
    6. Wheeler A
    Acute Respiratory Distress Syndrome Network; Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. Survey of Anesthesiology 2001;45(1):19-20.
    OpenUrl
  8. 8.↵
    1. Amato MBP,
    2. Meade MO,
    3. Slutsky AS,
    4. Brochard L,
    5. Costa ELV,
    6. Schoenfeld DA,
    7. et al
    . Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015;372(8):747-755.
    OpenUrlCrossRefPubMed
  9. 9.↵
    1. Goligher EC,
    2. Costa ELV,
    3. Yarnell CJ,
    4. Brochard LJ,
    5. Stewart TE,
    6. Tomlinson G,
    7. et al
    . Effect of lowering VT on mortality in acute respiratory distress syndrome varies with respiratory system elastance. Am J Respir Crit Care Med 2021;203(11):1378-1385.
    OpenUrl
  10. 10.↵
    1. Tonna JE,
    2. Peltan I,
    3. Brown SM,
    4. Herrick JS,
    5. Keenan HT,
    6. Grissom CK,
    7. et al
    ; University of Utah Mechanical Power Study Group. Mechanical power and driving pressure as predictors of mortality among patients with ARDS. Intensive Care Med 2020;46(10):1941-1943.
    OpenUrl
  11. 11.↵
    1. Gattinoni L,
    2. Tonetti T,
    3. Cressoni M,
    4. Cadringher P,
    5. Herrmann P,
    6. Moerer O,
    7. et al
    . Ventilator-related causes of lung injury: the mechanical power. Intensive Care Med 2016;42(10):1567-1575.
    OpenUrlCrossRefPubMed
  12. 12.↵
    1. Rocco PRM,
    2. Silva PL,
    3. Samary CS,
    4. Hayat Syed MK,
    5. Marini JJ
    . Elastic power but not driving power is the key promoter of ventilator-induced lung injury in experimental acute respiratory distress syndrome. Crit Care 2020;24(1):284.
    OpenUrl
  13. 13.
    1. Parhar KKS,
    2. Zjadewicz K,
    3. Soo A,
    4. Sutton A,
    5. Zjadewicz M,
    6. Doig L,
    7. et al
    . Epidemiology, mechanical power, and 3-year outcomes in acute respiratory distress syndrome patients using standardized screening. An observational cohort study. Ann Am Thorac Soc 2019;16(10):1263-1272.
    OpenUrlCrossRef
  14. 14.↵
    1. Zhang Z,
    2. Zheng B,
    3. Liu N,
    4. Ge H,
    5. Hong Y
    . Mechanical power normalized to predicted body weight as a predictor of mortality in patients with acute respiratory distress syndrome. Intensive Care Med 2019;45(6):856-864.
    OpenUrl
  15. 15.↵
    1. Serpa Neto A,
    2. Deliberato RO,
    3. Johnson AEW,
    4. Bos LD,
    5. Amorim P,
    6. Pereira SM,
    7. et al
    ; PROVE Network Investigators. Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts. Intensive Care Med 2018;44(11):1914-1922.
    OpenUrlPubMed
  16. 16.
    1. Lanspa MJ,
    2. Gong MN,
    3. Schoenfeld DA,
    4. Lee KT,
    5. Grissom CK,
    6. Hou PC,
    7. et al
    . Prospective assessment of the feasibility of a trial of low tidal volume ventilation for patients with acute respiratory failure. Annals ATS 2019;16(3):356-362.
    OpenUrl
  17. 17.↵
    1. Costa ELV,
    2. Slutsky AS,
    3. Brochard LJ,
    4. Brower R,
    5. Serpa-Neto A,
    6. Cavalcanti AB,
    7. et al
    . Ventilatory variables and mechanical power in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2021;204(3):303-311.
    OpenUrl
  18. 18.↵
    1. Pereira Romano ML,
    2. Maia IS,
    3. Laranjeira LN,
    4. Damiani LP,
    5. Paisani D. D M,
    6. Borges M. D C,
    7. et al
    . Driving pressure-limited strategy for patients with acute respiratory distress syndrome. A pilot randomized clinical trial. Ann Am Thorac Soc 2020;17(5):596-604.
    OpenUrlCrossRef
  19. 19.↵
    1. Sahetya SK,
    2. Hager DN,
    3. Stephens RS,
    4. Needham DM,
    5. Brower RG
    . PEEP titration to minimize driving pressure in subjects with ARDS: a prospective physiological study. Respir Care 2020;65(5):583-589.
    OpenUrlAbstract/FREE Full Text
  20. 20.↵
    1. Maggiore SM,
    2. Richard J-C,
    3. Brochard L
    . What has been learnt from P/V curves in patients with acute lung injury/acute respiratory distress syndrome. Eur Respir J Suppl 2003;42(42 suppl):22s-26s.
    OpenUrl
  21. 21.↵
    1. Johnson AEW,
    2. Pollard TJ,
    3. Shen L,
    4. Lehman LH,
    5. Feng M,
    6. Ghassemi M,
    7. et al
    . MIMIC-III, a freely accessible critical care database. Sci Data 2016;3(1):160035.
    OpenUrl
  22. 22.↵
    1. Ferguson ND,
    2. Fan E,
    3. Camporota L,
    4. Antonelli M,
    5. Anzueto A,
    6. Beale R,
    7. et al
    . The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material. Intensive Care Med 2012;38(10):1573-1582.
    OpenUrlCrossRefPubMedWeb of Science
  23. 23.↵
    1. Irvin J,
    2. Rajpurkar P,
    3. Ko M,
    4. Yu Y,
    5. Ciurea-Ilcus S,
    6. Chute C,
    7. et al
    . CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison. 2019; arXiv:1901.07031.
  24. 24.↵
    1. Hernan M,
    2. Robins JM
    . Causal inference: what if. Boca Raton: Chapman and Hall/CRC; 2020.
  25. 25.↵
    1. Baedorf Kassis E,
    2. Loring SH,
    3. Talmor D
    . Mortality and pulmonary mechanics in relation to respiratory system and transpulmonary driving pressures in ARDS. Intensive Care Med 2016;42(8):1206-1213.
    OpenUrl
  26. 26.↵
    1. Loring SH,
    2. Malhotra A
    . Driving pressure and respiratory mechanics in ARDS. N Engl J Med 2015;372(8):776-777.
    OpenUrlPubMed
  27. 27.↵
    1. Protti A,
    2. Maraffi T,
    3. Milesi M,
    4. Votta E,
    5. Santini A,
    6. Pugni P,
    7. et al
    . Role of strain rate in the pathogenesis of ventilator-induced lung edema. Crit Care Med 2016;44(9):e838-e845.
    OpenUrlCrossRefPubMed
  28. 28.↵
    1. Schaefer MS,
    2. Loring SH,
    3. Talmor D,
    4. Baedorf-Kassis EN
    . Comparison of mechanical power estimations in mechanically ventilated patients with ARDS: a secondary data analysis from the EPVent study. Intensive Care Med 2021;47(1):130-132.
    OpenUrl
  29. 29.↵
    1. Maggiore SM,
    2. Jonson B,
    3. Richard J-C,
    4. Jaber S,
    5. Lemaire F,
    6. Brochard L
    . Alveolar de-recruitment at decremental positive end-expiratory pressure levels in acute lung injury. Am J Respir Crit Care Med 2001;164(5):795-801.
    OpenUrlCrossRefPubMedWeb of Science
  30. 30.
    1. Costa ELV,
    2. Borges JB,
    3. Melo A,
    4. Suarez-Sipmann F,
    5. Toufen CJ,
    6. Bohm SH,
    7. et al
    . Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography. Intensive Care Med 2009;35(6):1132-1137.
    OpenUrlCrossRefPubMedWeb of Science
  31. 31.
    1. Sarge T,
    2. Baedorf-Kassis E,
    3. Banner-Goodspeed V,
    4. Novack V,
    5. Loring SH,
    6. Gong MN,
    7. et al
    ; EPVent-2 Study Group. Effect of esophageal pressure-guided positive end-expiratory pressure on survival from acute respiratory distress syndrome: a risk-based and mechanistic re-analysis of the EPVent-2 Trial. Am J Respir Crit Care Med 2021;204(10):1153-1163.
    OpenUrlPubMed
  32. 32.
    Writing Group for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) Investigators. Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 2017;318(14):1335-1345.
    OpenUrlCrossRefPubMed
  33. 33.↵
    1. Brochard L,
    2. Chen L,
    3. Goligher E
    . Optimum positive end-expiratory pressure 40 years later. Indian J Crit Care Med 2014;18(8):494-496.
    OpenUrl
  34. 34.↵
    1. Liebler JM,
    2. Qu Z,
    3. Buckner B,
    4. Powers MR,
    5. Rosenbaum JT
    . Fibroproliferation and mast cells in the acute respiratory distress syndrome. Thorax 1998;53(10):823-829.
    OpenUrlAbstract/FREE Full Text
  35. 35.
    1. Harris RS,
    2. Hess DR,
    3. Venegas JG
    . An objective analysis of the pressure-volume curve in the acute respiratory distress syndrome. Am J Respir Crit Care Med 2000;161(2 Pt 1):432-439.
    OpenUrlCrossRefPubMedWeb of Science
  36. 36.↵
    1. Gattinoni L,
    2. Pelosi P,
    3. Suter PM,
    4. Pedoto A,
    5. Vercesi P,
    6. Lissoni A
    . Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease: different syndromes? Am J Respir Crit Care Med 1998;158(1):3-11.
    OpenUrlCrossRefPubMedWeb of Science
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Respiratory Care
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Titration of Ventilator Settings to Target Driving Pressure and Mechanical Power
Elias N Baedorf Kassis, Stephanie Hu, MingYu Lu, Alistair E W Johnson, Somnath Bose, Maximilian S Schaefer, Daniel S Talmor, Li-Wei H Lehman, Zach S Shahn
Respiratory Care Feb 2023, 68 (2) 199-207; DOI: 10.4187/respcare.10258

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Titration of Ventilator Settings to Target Driving Pressure and Mechanical Power
Elias N Baedorf Kassis, Stephanie Hu, MingYu Lu, Alistair E W Johnson, Somnath Bose, Maximilian S Schaefer, Daniel S Talmor, Li-Wei H Lehman, Zach S Shahn
Respiratory Care Feb 2023, 68 (2) 199-207; DOI: 10.4187/respcare.10258
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Keywords

  • ARDS
  • driving pressure
  • mechanical power
  • power
  • mechanical ventilation
  • PEEP
  • tidal volume
  • modeling

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