Patient Self-Induced Lung Injury

ARDS patients resuming spontaneous breathing may generate strong inspiratory efforts that increase transpulmonary pressure and contribute to PSILI. Respiratory drive may be increased by lung and systemic inflammation, activation of unmyelinated afferent fibres, slow and rapid adaptive receptors, nociceptor stimuli, and a blunted inhibitory response to lung inflation. High respiratory drive has been associated with prolonged mechanical ventilation and increased mortality, especially in ARDS and COVID-19 ARDS. P0.1 is used as a ventilator-based marker of respiratory drive, with a target of 1 to 3.9 cm H2O in the experimental group.