However, clinical trials have found conflicting responses to the manipulation of these separate components of lung protection and when the optimization of one component negatively affects another it is often unclear at the bedside which is preferred.Important components of these strategies all decrease stress on the lung:.Protective lung ventilation strategies and ‘open lung’ approaches are associated with less ventilator-induced lung injury (VILI), improved oxygenation and improved outcomes.Driving pressure (ΔP) can be calculated at the bedside as plateau pressure minus positive end-expiratory pressure (P plat – PEEP). Driving pressure (ΔP) is the ratio of tidal volume to (static) respiratory system compliance i.e.Driving pressure has been suggested by Amato and colleagues to be the key variable for optimisation when performing mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). Reviewed and revised 22 December 2015 co-authored by Jack Iwashyna ( who provided the analysis of the Amato et al, 2015 trial
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