The airway occlusion pressure (P_0.1) to monitor respiratory drive during mechanical ventilation: increasing awareness of a not-so-new problem

Excerpt

An inadequate respiratory drive under mechanical ventilation, either too high or too low, has recently been incriminated as a risk factor for both lung [1] and diaphragmatic injury [2]. Monitoring and controlling the drive to breathe might, therefore, be important for clinical practice. However, respiratory drive assessment has mostly been limited to research purposes, with few techniques available at the bedside [3]. A simple non-invasive measure, the airway occlusion pressure (P_0.1), i.e. the pressure developed in the occluded airway 100 ms after the onset of inspiration (Fig. 1), was first described 40 years ago. Currently, nearly all modern ventilators provide a means of measuring P_0.1. Despite having a better understanding of the importance of the respiratory drive during mechanical ventilation, no recommendations exist about its use.

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