Preventing Lung injury in ARDS- Ranieri (Keynote 25th Sept 2017) #LIVES2017

Claudio Ranieri starts us off with a discussion and reminder about the importance of transpulmonary pressure- elegantly described in this excellent NEJM paper …

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Titrating ventilation to transpulmonary pressure may have a mortality benefit, as seen in this H1N1 series…

Spontaneous breathing isn’t always protective- extreme negative intrathoracic pressures can cause large increases in transpulmonary pressure

Targeting low transpulmonary pressures isn’t just of benefit to those with ARDS- surgical patients (…) and organ donors ( have both seen benefits from a lung protective approach.

There is some evidence that ventilator induced lung injury causes direct neurological damage ( could this be directly contributing to the delirium we see?



Try Jon-Emile Kenny’s excellent pulmonary physiology series here…


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