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Transpulmonary pressure guided ventilation strategy for patients with severe acute respiratory distress syndrome treated with venovenous extracorporeal membrane oxygenation

Rui Wang, Bing Sun

Our team published an article involving a Transpulmonary Pressure (Ptp)-guided ventilation strategy for patients with severe Acute Respiratory Distress Syndrome (ARDS) treated with Venovenous Extracorporeal Membrane Oxygenation (VV-ECMO) in a recent issue of Critical Care Medicine. The higher Positive End-Expiratory Pressure (PEEP) and lower driving pressure were used in the Ptpguided strategy. Moreover, the changes in respiratory mechanics resulted in stabilization of lung morphology and reduction of serum cytokine concentration. Finally, a lower degree of Ventilator- Induced Lung Injury (VILI) was associated with faster improvement in lung function and more successful weaning from ECMO support. The Ptp-guided ventilation strategy which we propose is an improvement of the lung rest strategy. The optimal ventilation strategy during VV-ECMO support warrants further research