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Eleonora Balzani, Glasiele C. Alcala, Giacomo Bellani, Antonio Pesenti
Mechanical ventilation is essential in acute hypoxemic respiratory failure (AHRF), yet excessive respiratory drive and inspiratory effort may aggravate injury, termed patient self-inflicted lung injury (P-SILI). Preclinical studies show that vigorous inspiratory efforts can lead to lung and diaphragm damage. Clinical investigations confirm that high drive and effort increase lung stress and are linked to worse outcomes. The review discusses various strategies to prevent P-SILI, including the use of positive end-expiratory pressure (PEEP), sedation, and neuromuscular blockade.
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