Predictors of VILI risk: driving pressure, 4DPRR and mechanical power ratio—an experimental study
Abstract Background Ventilator-induced lung injury (VILI) is one of the side effects of mechanical ventilation during ARDS; a prerequisite for averting it is the quantification of its risk factors associated with a given ventilatory setting. Many clinical variables have been proposed as predictors o...
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| Language: | English |
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SpringerOpen
2024-12-01
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| Series: | Intensive Care Medicine Experimental |
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| Online Access: | https://doi.org/10.1186/s40635-024-00697-6 |
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| author | Mauro Galizia Valentina Ghidoni Giulia Catozzi Stefano Giovanazzi Domenico Nocera Beatrice Donati Tommaso Pozzi Rosanna D’Albo Mattia Busana Federica Romitti Peter Herrmann Onnen Moerer Konrad Meissner Michael Quintel Luigi Camporota Luciano Gattinoni |
| author_facet | Mauro Galizia Valentina Ghidoni Giulia Catozzi Stefano Giovanazzi Domenico Nocera Beatrice Donati Tommaso Pozzi Rosanna D’Albo Mattia Busana Federica Romitti Peter Herrmann Onnen Moerer Konrad Meissner Michael Quintel Luigi Camporota Luciano Gattinoni |
| author_sort | Mauro Galizia |
| collection | DOAJ |
| description | Abstract Background Ventilator-induced lung injury (VILI) is one of the side effects of mechanical ventilation during ARDS; a prerequisite for averting it is the quantification of its risk factors associated with a given ventilatory setting. Many clinical variables have been proposed as predictors of VILI, of which driving pressure is the most widely used. In this study, we compared the performance of driving pressure, four times the driving pressure added to respiratory rate (4DPRR) and mechanical power ratio. Results In a study population of 121 previously healthy pigs exposed to harmful ventilation, we compared the association of driving pressure, 4DPRR and mechanical power ratio to lung weight, lung wet-to-dry and total histological score. All the three variables were associated with these outcomes. Driving pressure, 4DPRR and mechanical power ratio increase linearly with the lung weight (adjusted R 2 of 0.27, 0.36 and 0.40, respectively), the lung wet-to-dry ratio (adjusted R 2 of 0.19, 0.25 and 0.37) and the total histological score (adjusted R 2 of 0.26, 0.38 and 0.26). Using a multiple linear regression model with forward analysis, starting with tidal volume and progressively adding respiratory rate and positive end-expiratory pressure, and comparing the topic with the outcome variables, we obtained R2 values, respectively, of 0.07, 0.20, 0.42 for lung weight, 0.09, 0.19, 0.26 for lung wet-to-dry ratio and 0.07, 0.27, 0.43 for total histological score. Conclusions Driving pressure, 4DPRR and mechanical power ratio, were all associated with lung injury in healthy animals undergoing mechanical ventilation. |
| format | Article |
| id | doaj-art-a07e79828b034ebbaa483a072001ab0d |
| institution | OA Journals |
| issn | 2197-425X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Intensive Care Medicine Experimental |
| spelling | doaj-art-a07e79828b034ebbaa483a072001ab0d2025-08-20T02:37:57ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2024-12-011211910.1186/s40635-024-00697-6Predictors of VILI risk: driving pressure, 4DPRR and mechanical power ratio—an experimental studyMauro Galizia0Valentina Ghidoni1Giulia Catozzi2Stefano Giovanazzi3Domenico Nocera4Beatrice Donati5Tommaso Pozzi6Rosanna D’Albo7Mattia Busana8Federica Romitti9Peter Herrmann10Onnen Moerer11Konrad Meissner12Michael Quintel13Luigi Camporota14Luciano Gattinoni15Department of Anaesthesiology, University Medical Center GöttingenDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Health Sciences, University of MilanDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of BolognaDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Anaesthesiology, University Medical Center GöttingenDepartment of Adult Critical Care, Guy’s and St. Thomas’ NHS Foundation Trust, Health Centre for Human and Applied Physiological SciencesDepartment of Anaesthesiology, University Medical Center GöttingenAbstract Background Ventilator-induced lung injury (VILI) is one of the side effects of mechanical ventilation during ARDS; a prerequisite for averting it is the quantification of its risk factors associated with a given ventilatory setting. Many clinical variables have been proposed as predictors of VILI, of which driving pressure is the most widely used. In this study, we compared the performance of driving pressure, four times the driving pressure added to respiratory rate (4DPRR) and mechanical power ratio. Results In a study population of 121 previously healthy pigs exposed to harmful ventilation, we compared the association of driving pressure, 4DPRR and mechanical power ratio to lung weight, lung wet-to-dry and total histological score. All the three variables were associated with these outcomes. Driving pressure, 4DPRR and mechanical power ratio increase linearly with the lung weight (adjusted R 2 of 0.27, 0.36 and 0.40, respectively), the lung wet-to-dry ratio (adjusted R 2 of 0.19, 0.25 and 0.37) and the total histological score (adjusted R 2 of 0.26, 0.38 and 0.26). Using a multiple linear regression model with forward analysis, starting with tidal volume and progressively adding respiratory rate and positive end-expiratory pressure, and comparing the topic with the outcome variables, we obtained R2 values, respectively, of 0.07, 0.20, 0.42 for lung weight, 0.09, 0.19, 0.26 for lung wet-to-dry ratio and 0.07, 0.27, 0.43 for total histological score. Conclusions Driving pressure, 4DPRR and mechanical power ratio, were all associated with lung injury in healthy animals undergoing mechanical ventilation.https://doi.org/10.1186/s40635-024-00697-6Ventilator-induced lung injuryMechanical powerARDSDriving pressureMechanical ventilation |
| spellingShingle | Mauro Galizia Valentina Ghidoni Giulia Catozzi Stefano Giovanazzi Domenico Nocera Beatrice Donati Tommaso Pozzi Rosanna D’Albo Mattia Busana Federica Romitti Peter Herrmann Onnen Moerer Konrad Meissner Michael Quintel Luigi Camporota Luciano Gattinoni Predictors of VILI risk: driving pressure, 4DPRR and mechanical power ratio—an experimental study Intensive Care Medicine Experimental Ventilator-induced lung injury Mechanical power ARDS Driving pressure Mechanical ventilation |
| title | Predictors of VILI risk: driving pressure, 4DPRR and mechanical power ratio—an experimental study |
| title_full | Predictors of VILI risk: driving pressure, 4DPRR and mechanical power ratio—an experimental study |
| title_fullStr | Predictors of VILI risk: driving pressure, 4DPRR and mechanical power ratio—an experimental study |
| title_full_unstemmed | Predictors of VILI risk: driving pressure, 4DPRR and mechanical power ratio—an experimental study |
| title_short | Predictors of VILI risk: driving pressure, 4DPRR and mechanical power ratio—an experimental study |
| title_sort | predictors of vili risk driving pressure 4dprr and mechanical power ratio an experimental study |
| topic | Ventilator-induced lung injury Mechanical power ARDS Driving pressure Mechanical ventilation |
| url | https://doi.org/10.1186/s40635-024-00697-6 |
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