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Intensive Care Medicine
Erschienen in: Intensive Care Medicine 4/2020

03.02.2020 | Narrative Review

Respiratory drive in the acute respiratory distress syndrome: pathophysiology, monitoring, and therapeutic interventions

verfasst von: Elena Spinelli, Tommaso Mauri, Jeremy R. Beitler, Antonio Pesenti, Daniel Brodie

Erschienen in: Intensive Care Medicine | Ausgabe 4/2020

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Abstract

Neural respiratory drive, i.e., the activity of respiratory centres controlling breathing, is an overlooked physiologic variable which affects the pathophysiology and the clinical outcome of acute respiratory distress syndrome (ARDS). Spontaneous breathing may offer multiple physiologic benefits in these patients, including decreased need for sedation, preserved diaphragm activity and improved cardiovascular function. However, excessive effort to breathe due to high respiratory drive may lead to patient self-inflicted lung injury (P-SILI), even in the absence of mechanical ventilation. In the present review, we focus on the physiological and clinical implications of control of respiratory drive in ARDS patients. We summarize the main determinants of neural respiratory drive and the mechanisms involved in its potentiation, in health and ARDS. We also describe potential and pitfalls of the available bedside methods for drive assessment and explore classical and more “futuristic” interventions to control drive in ARDS patients.
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Metadaten
Titel
Respiratory drive in the acute respiratory distress syndrome: pathophysiology, monitoring, and therapeutic interventions
verfasst von
Elena Spinelli
Tommaso Mauri
Jeremy R. Beitler
Antonio Pesenti
Daniel Brodie
Publikationsdatum
03.02.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 4/2020
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-020-05942-6

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