CARDIOPULMONARY MONITORINGDriving pressure monitoring during acute respiratory failure in 2020Chen, Lua,b; Jonkman, Annemijna,b,c; Pereira, Sérgio M.a,b,d; Lu, Conga,b; Brochard, Laurenta,bAuthor Information aKeenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, and Department of Critical Care Medicine, St. Michael's Hospital bInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada cDepartment of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands dLaboratório de Pneumologia LIM–09, Disciplina de Pneumologia, Instituto do Coração (Incor) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Correspondence to Laurent Brochard, 209 Victoria Street, Room 408, Toronto, Ontario, M5B 1T8, Canada. Tel: +1 416 864 5686; e-mail: [email protected] Current Opinion in Critical Care: June 2021 - Volume 27 - Issue 3 - p 303-310 doi: 10.1097/MCC.0000000000000827 Buy Metrics Abstract Purpose of review Assess the most recent studies using driving pressure (DP) as a monitoring technique under mechanical ventilation and describe the technical challenges associated with its measurement. Recent findings DP is consistently associated with survival in acute respiratory failure and acute respiratory distress syndrome (ARDS) and can detect patients at higher risk of ventilator-induced lung injury. Its measurement can be challenged by leaks and ventilator dyssynchrony, but is also feasible under pressure support ventilation. Interestingly, an aggregated summary of published results suggests that its level is on average slightly lower in patients with coronavirus disease-19 induced ARDS than in classical ARDS. Summary The DP is easy to obtain and should be incorporated as a minimal monitoring technique under mechanical ventilation. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.