Korean J Anesthesiol.  2020 Jun;73(3):194-204. 10.4097/kja.20041.

Driving pressure guided ventilation

  • 1Department of Anesthesiology and Pain Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Anesthesiology and Pain Medicine Yonsei University College of Medicine, Seoul, Korea
  • 4Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea


Protective ventilation is a prevailing ventilatory strategy these days and is comprised of small tidal volume, limited inspiratory pressure, and application of positive end-expiratory pressure (PEEP). However, several retrospective studies recently suggested that tidal volume, inspiratory pressure, and PEEP are not related to patient outcomes, or only related when they influence the driving pressure. Therefore, this review introduces the concept of driving pressure and looks into the possibility of driving pressure-guided ventilation as a new ventilatory strategy, especially in thoracic surgery where postoperative pulmonary complications are common, and thus, lung protection is of utmost importance.


Driving pressure; Positive end-expiratory pressure; Postoperative complications; Protective ventilation
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