Comparison of efficacy of transpulmnary pressure and driving pressure in guiding lung-protective ventilation strategies for patients with acute respiratory distress syndrome
10.3760/cma.j.cn131073-20240527-00414
- VernacularTitle:Ptp与DP用于指导ARDS患者肺保护性通气策略效果的比较
- Author:
Yaoyao TANG
1
;
Yan LI
;
Wenli MENG
;
Zhiyong WANG
;
Mingxing FANG
Author Information
1. 河北医科大学第三医院重症医学科，石家庄 050051
- Publication Type:Journal Article
- Keywords:
Respiratory distress syndrome;
Pulmonary ventilation;
Ventilator-induced lung injury;
Transpulmonary pressure;
Driving pressure
- From:
Chinese Journal of Anesthesiology
2025;45(4):458-462
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of transpulmonary pressure (Ptp) and driving pressure (DP) in guiding lung-protective ventilation strategies in patients with acute respiratory distress syndrome (ARDS).Methods:In this randomized controlled trial, 22 ARDS patients of either sex, aged 18-80 yr, with a body mass index of 18-30 kg/m 2, were divided into 2 groups ( n=11 each) using a random number table method: Ptp group and DP group. DP group received a tidal volume of 4-6 ml/kg with a plateau pressure<30 cmH 2O (1 cm H 2O=0.098 kPa) and driving pressure<16 cmH 2O. In Ptp group, the positive end-expiratory pressure (PEEP) and tidal volume were adjusted to maintain end-inspiratory Ptp <25 cmH 2O and end-expiratory Ptp 0-5 cmH 2O based on the setting mentioned in DP group. Oxygenation index, PEEP, plateau pressure, central venous pressure, heart rate, mean arterial pressure, parameters of liver and kidney function, mechanical ventilation duration, and the mortality in the intensive care unit were recorded on admission to the operating room and at 24 and 48 h after treatment. Results:Compared to DP group, significant changes were found in the main effects of oxygenation indices and time effects in Ptp group, and significant changes were found in the main effect of PEEP, with mean arterial pressure increasing ( P<0.05), and no significant differences were observed in the other parameters regarding group effects, time effects, or interactions in PEEP group ( P>0.05). Conclusions:Ptp provides a superior efficacy than DP in guiding lung-protective ventilation strategies for the patients with ARDS.
