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Driving pressure guided ventilation

대한마취과학회지 2020년 73권 3호 p.194 ~ 204
안현주 ( Ahn Hyun-Joo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine

박미혜 ( Park Mi-Hye ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine
 ( Kim Jie-Ae ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine
양미경 ( Yang Mi-Kyung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Anesthesiology and Pain Medicine
 ( Yoon Su-Sie ) - Seoul National University College of Medicine Seoul National University Hospital Department of Anesthesiology and Pain Medicine
김보림 ( Kim Bo-Rim ) - Seoul National University College of Medicine Seoul National University Hospital Department of Anesthesiology and Pain Medicine
박재현 ( Bahk Jae-Hyon ) - Seoul National University College of Medicine Seoul National University Hospital Department of Anesthesiology and Pain Medicine
오영준 ( Oh Young-Jun ) - Yonsei University College of Medicine Department of Anesthesiology and Pain Medicine
이은호 ( Lee Eun-Ho ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine

Abstract


Protective ventilation is a prevailing ventilatory strategy these days and is comprised of small tidal volume, limited inspiratory pressure, and application of positive end-expiratory pressure (PEEP). However, several retrospective studies recently suggested that tidal volume, inspiratory pressure, and PEEP are not related to patient outcomes, or only related when they influence the driving pressure. Therefore, this review introduces the concept of driving pressure and looks into the possibility of driving pressure-guided ventilation as a new ventilatory strategy, especially in thoracic surgery where postoperative pulmonary complications are common, and thus, lung protection is of utmost importance.

키워드

Driving pressure; Positive end-expiratory pressure; Postoperative complications; Protective ventilation
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