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- Title
Positive or negative pressure: plus ça change, plus c'est la même chose.
- Authors
Camporota, Luigi; Collino, Francesca; Gattinoni, Luciano
- Abstract
This document is a comment on a correspondence article regarding the management of acute respiratory distress syndrome (ARDS) and the use of negative pressure ventilation (NPV). The authors agree that NPV is often overlooked in ARDS management, but they argue that ventilatory induced lung injury (VILI) is primarily caused by excessive strain on the lungs, rather than the positive or negative airway pressure itself. They explain that the risk of VILI depends on the ratio between lung elastance and total respiratory system elastance, and that excessive negative pleural pressure can have pulmonary and hemodynamic consequences. The authors remain skeptical about the effectiveness of negative pressure ventilation and suggest that extracorporeal support may be necessary to mitigate injury risks.
- Subjects
NONINVASIVE ventilation; ARTIFICIAL respiration; HYPERVENTILATION; ADULT respiratory distress syndrome; POSITIVE pressure ventilation
- Publication
Intensive Care Medicine, 2024, Vol 50, Issue 5, p802
- ISSN
0342-4642
- Publication type
Article
- DOI
10.1007/s00134-024-07433-4