Table 2.

Clinical Recommendations Regarding Driving Pressure and ARDS

Driving pressure should not be used in isolation but should be interpreted in the context of PEEP, VT, and lung mechanics.

Elevated driving pressure should prompt a bedside assessment regarding how best to change settings and lower the driving pressure, e.g., reducing VT, diuresis, or sedation.

To the extent possible, driving pressure should be reduced through time, recognizing that hypercapnia, dyspnea, and patient/ventilator dyssynchrony may occur with low-minute ventilation.

In patients at risk of ARDS, minimizing driving pressure may be associated with reduced risk of incident ARDS. Data regarding clinical benefits are less compelling than established ARDS.

ARDS, acute respiratory distress syndrome; PEEP, positive end-expiratory pressure; V_T, tidal volume.