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01-11-2018 | What's New in Intensive Care

Is my patient’s respiratory drive (too) high?

Authors: Irene Telias, Laurent Brochard, Ewan C. Goligher

Published in: Intensive Care Medicine | Issue 11/2018

Excerpt

The intensity of the neural stimulus to breathe is called “respiratory drive” [1] and plays a major role in acute respiratory failure before, during, and after mechanical ventilation. Respiratory drive modulates inspiratory effort (the pressure generated by the respiratory muscles) according to metabolic needs through various feedback control mechanisms. It primarily responds to chemical inputs from the central and peripheral chemoreceptors. Additional stimuli arise from mechanoreceptors and vagal inputs (from chest wall, respiratory muscles, airways, and lungs) [1]. The control of breathing is also influenced by behavioral factors and activities (talking, swallowing, exercise), pain (e.g., post-operative patients), temperature, and inflammatory chemokines (e.g., during endotoxemia). Brainstem inflammation may also directly influence the control of breathing [2]. Patients with acute respiratory failure may exhibit high respiratory drive due to deranged gas exchange, high metabolic demands, and/or intense mechanical stimuli. Respiratory drive may also be increased, modified, or even suppressed by acute neurological insults such as stroke or traumatic brain injury. …

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Title: Is my patient’s respiratory drive (too) high?
Authors: Irene Telias
Laurent Brochard
Ewan C. Goligher
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 11/2018
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-018-5091-2

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Is my patient’s respiratory drive (too) high?

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