Driving Pressure: The Return of Physiology in Pediatric Mechanical Ventilation by M. Kneyber

In this World Shared Practice Forum podcast, Dr. Martin Kneyber, Chief of the Division of Paediatric Critical Care Medicine at the Beatrix Children’s Hospital, provides an insightful overview of the current state of thinking regarding the concepts of mechanical power and driving pressure in adult and pediatric mechanical ventilation. He provides his perspective on current evidence-based best practices for lung protective ventilation in pediatric ARDS, and highlights important areas for ongoing and future research. Learning Objectives: -Review the concepts and interrelations between mechanical power, driving pressure, plateau pressure -Understand the state of evidence linking driving pressure to outcomes in adult and pediatric patients receiving mechanical ventilation -Describe current evidence-based best clinical practices in adjusting mechanical ventilation in pediatric patients with acute respiratory distress syndrome (ARDS) Articles referenced: • Kneyber MC. Driving Pressure and Mechanical Power: The Return of Physiology in Pediatric Mechanical Ventilation. Pediatric Critical Care Medicine. 2021 Oct 1;22(10):927-9. (00:57) • Díaz, Franco, González-Dambrauskas, Sebastián, Cristiani, Federico, Casanova, Daniel R., Cruces, Pablo, Driving Pressure and Normalized Energy Transmission Calculations in Mechanically Ventilated Children Without Lung Disease and Pediatric Acute Respiratory Distress Syndrome, Pediatric Critical Care Medicine: 2021 Oct 1;22(10):870-8 (2:01) • Amato MB, Meade MO, Slutsky AS, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med. 2015;372(8):747-755. (5:58) • van Schelven P, Koopman AA, Burgerhof JGM, Markhorst DG, Blokpoel RGT, Kneyber MCJ. Driving Pressure Is Associated With Outcome in Pediatric Acute Respiratory Failure [published online ahead of print, 2021 Oct 20]. Pediatr Crit Care Med. 2021;10.1097/PCC.0000000000002848.(8:17) Publication Date: November 22, 2021. Citation: Kneyber M, Daniel D, Burns JP. Driving Pressure: The return of physiology in pediatric mechanical ventilation. 11/2021. Online Podcast. OPENPediatrics. https://soundcloud.com/openpediatrics/driving-pressure-the-return-of-physiology-in-pediatric-mechanical-ventilation-dr-martin-kneyber. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching a full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu