Mean airway pressure as a parameter of lung-protective and heart-protective ventilation.
Rev Esp Anestesiol Reanim (Engl Ed)
; 71(6): 466-478, 2024.
Article
en En
| MEDLINE
| ID: mdl-38615712
ABSTRACT
Mean airway pressure (MAP) is the mean pressure generated in the airway during a single breath (inspirationâ¯+â¯expiration), and is displayed on most anaesthesia and intensive care ventilators. This parameter, however, is not usually monitored during mechanical ventilation because it is poorly understood and usually only used in research. One of the main determinants of MAP is PEEP. This is because in respiratory cycles with an IE ratio of 12, expiration is twice as long as inspiration. Although MAP can be used as a surrogate for mean alveolar pressure, these parameters differ considerably in some situations. Recently, MAP has been shown to be a useful prognostic factor for respiratory morbidity and mortality in mechanically ventilated patients of various ages. Low MAP has been associated with a lower incidence of 90-day mortality, shorter ICU stay, and shorter mechanical ventilation time. MAP also affects haemodynamics there is evidence of a causal relationship between high MAP and low perfusion index, both of which are associated with poor prognosis in mechanically ventilated patients. Elevated MAP values have also been associated with high central venous pressure and lactate, which are indicative of ventilator-associated right ventricular failure and tissue hypoperfusion, respectively. MAP, therefore, is an important parameter to measure in clinical practice. The aim of this review has been to identify the determinants of MAP, the pros and cons of using MAP instead of traditional protective ventilation parameters, and the evidence that supports the use of MAP in clinical practice.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Respiración Artificial
Límite:
Humans
Idioma:
En
Revista:
Rev Esp Anestesiol Reanim (Engl Ed)
Año:
2024
Tipo del documento:
Article
Pais de publicación:
ES
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