title: Dynamic airway pressure-time curve profile (Stress Index): a systematic review.
abstract: The assessment of respiratory mechanics at the bedside is necessary in order to identify the most protective ventilatory strategy. Indeed in the last 20 years, adverse effects of positive ventilation to the lung structures have led to a reappraisal of the objectives of mechanical ventilation. The ventilator setting requires repeated readjustment over the period of mechanical ventilation dependency and careful respiratory monitoring to minimize the risks, preventing further injury and permitting the lung and airways healing. Among the different methods that have been proposed and validated, the analysis of dynamic P-t curve (named Stress Index, SI) represents an adequate tool available at the bedside, repeatable and, therefore, able to identify the amount of overdistension occurring in the daily clinical practice, when modifying positive end-expiratory pressure. In this review we will analyze the evidence that supports respiratory mechanics assessment at the bedside and the application of the dynamic P/t curve profile (SI) to optimize protective ventilation in patients with acute respiratory failure.
authors: Dipartimento di Scienze Chirurgiche, Università di Torino, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italia - luciana.mascia@unito.it.
authors: Pierpaolo
authors: P
authors: Terragni
authors: Guido
authors: G
authors: Bussone
authors: Luciana
authors: L
authors: Mascia
mesh_terms: D006801:Humans; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy; D015656:Respiratory Mechanics / Q000502:physiology*; D055397:Ventilator-Induced Lung Injury / Q000503:physiopathology / Q000517:prevention & control