An importance of respiratory drive and effort during mechanical ventilation

During mechanical ventilation, minimizing respiratory drive and effort becomes routine to prevent patient-ventilator asynchrony (PVA). As we know, PAV associates with poor outcomes in ICU patients. As a result, prescribing sedative drugs in combination with neuro-muscular blocking agents commonly appears in many ICUs. However, many patients develop adverse events from unloading respiratory muscles, resulting in prolonged mechanical ventilator and bad clinical outcomes. This review describes both sides of the adverse effect of respiratory drive and effort and tries to suggest the optimum point, believing that it may be associated with better outcomes.