CHEST SEEK® Author Commentary (7 New Flashcards! June 2026)-Indeterminate Driving Pressure - Commentary From Gregory A. Schmidt, MD, FCCP

Indeterminate Driving Pressure - Commentary From Gregory A. Schmidt, MD, FCCP

Video Transcription

Video Summary

Driving pressure is used to estimate transpulmonary pressure and potential lung injury from ventilation. In volume assist-control, it is usually plateau pressure minus PEEP; in pressure-control, it is inspiratory pressure minus expiratory pressure. However, this only works when the patient is passive and there is no auto-PEEP or strong spontaneous effort. The transcript explains that elevated respiratory rate and high P0.1 suggest high drive to breathe, making driving pressure indeterminate in the case shown. The key lesson: always confirm patient passivity and absence of auto-PEEP before interpreting driving pressure.

Asset Caption

This question is found in the Pulmonary Disease module in the Critical Care Medicine Collection.

Keywords

driving pressure

transpulmonary pressure

volume assist-control

pressure-control ventilation

auto-PEEP