<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0028-3746</journal-id>
<journal-title><![CDATA[Neumología y cirugía de tórax]]></journal-title>
<abbrev-journal-title><![CDATA[Neumol. cir. torax]]></abbrev-journal-title>
<issn>0028-3746</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Mexicana de Neumología y Cirugía de Tórax; Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas; Sociedad Cubana de Neumología; Sociedad Paraguaya de Neumología; Sociedad Boliviana de Neumología.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0028-37462018000300222</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Presión de distensión (driving pressure): Principal objetivo para la protección alveolar]]></article-title>
<article-title xml:lang="en"><![CDATA[Driving pressure: Main objective for alveolar protection]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Nieto]]></surname>
<given-names><![CDATA[Orlando Rubén]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Deloya-Tomás]]></surname>
<given-names><![CDATA[Ernesto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lomelí-Terán]]></surname>
<given-names><![CDATA[José Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pozos-Cortés]]></surname>
<given-names><![CDATA[Karen Pamela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Monares-Zepeda]]></surname>
<given-names><![CDATA[Enrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Poblano-Morales]]></surname>
<given-names><![CDATA[Manuel Nicolás]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General San Juan del Río  ]]></institution>
<addr-line><![CDATA[Querétaro Querétaro]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital San Ángel Inn  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital H+  ]]></institution>
<addr-line><![CDATA[Santiago de Querétaro Querétaro]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2018</year>
</pub-date>
<volume>77</volume>
<numero>3</numero>
<fpage>222</fpage>
<lpage>227</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0028-37462018000300222&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0028-37462018000300222&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0028-37462018000300222&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  El síndrome de distrés respiratorio agudo (SDRA) es una patología grave, común en las unidades de cuidados intensivos. La presión de distensión (DP, driving pressure), es una variable de la mecánica respiratoria asociada con mortalidad, que depende de la relación entre la distensibilidad pulmonar (Cst), la presión positiva al final de la espiración (PEEP) y el volumen corriente inspirado (Vt). Desarrollo: La DP ha demostrado ser la meta de protección pulmonar más relevante en los últimos años, cuyo control genera impacto en la supervivencia de los pacientes con SDRA. Es de fácil cálculo y puede medirse de forma rutinaria en los pacientes que no generan esfuerzo inspiratorio, con las fórmulas: PEEP-presión meseta o Vt/CRS (distensibilidad del sistema respiratorio).  Discusión:  La DP es una medida de protección alveolar reportada en 1998 y se relaciona directamente con la mortalidad en pacientes con SDRA, integra tres variables: Vt, PEEP y presión meseta, las cuales, de forma aislada, han demostrado relación directa con el pronóstico de esta patología.  Conclusión:  El control de la DP es el objetivo primario para la protección alveolar en pacientes con SDRA.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Background:  Acute respiratory distress syndrome (ARDS) is a serious pathology, common in the intensive care unit, driving pressure (DP) is a variable of the respiratory mechanics associated with mortality, which depends on the relationship between lung compliance (Cest), positive end-expiratory pressure (PEEP) and inspired tidal volume (Vt). Development: PD has been shown to be the most relevant lung protection goal in recent years, whose control has an impact on the survival of patients with ARDS, it is easy to calculate and can be measured routinely in patients who do not generate inspiratory effort, with the formulas: PEEP-Plateau pressure or Vt/CRS (respiratory system compliance).  Discussion:  PD is a measure of alveolar protection reported in 1998 and is directly related to mortality in patients with ARDS, DP integrates three variables: Vt, PEEP and plateau pressure, which in isolation have been shown to be directly related to the prognosis of this pathology.  Conclusion:  The control of DP is the primary objective for alveolar protection in patients with ARDS.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Ventilación mecánica]]></kwd>
<kwd lng="es"><![CDATA[presión de distensión]]></kwd>
<kwd lng="es"><![CDATA[síndrome de distrés respiratorio agudo]]></kwd>
<kwd lng="en"><![CDATA[Mechanical ventilation]]></kwd>
<kwd lng="en"><![CDATA[driving pressure]]></kwd>
<kwd lng="en"><![CDATA[acute respiratory distress syndrome]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bernard]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
<name>
<surname><![CDATA[Artigas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Brigham]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The American-European Consensus Conference on ARDS: definitions, mechanism, relevant outcomes, and clinical trial coordination]]></article-title>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>1994</year>
<volume>149</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>818-24</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Musch]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Venegas]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Bellani]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Regional gas exchange and cellular metabolic activity in ventilator- induced lung injury]]></article-title>
<source><![CDATA[Anesthesiology]]></source>
<year>2007</year>
<volume>106</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>723-35</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Temblay]]></surname>
<given-names><![CDATA[LN]]></given-names>
</name>
<name>
<surname><![CDATA[Miatto]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Hamid]]></surname>
<given-names><![CDATA[Q]]></given-names>
</name>
<name>
<surname><![CDATA[Govindarajan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Slutsky]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Injurious ventilation induces widespread pulmonary epithelial expression or tumor necrosis factor-alpha and interleukin-6 messenger RNA]]></article-title>
<source><![CDATA[Critical Care Med]]></source>
<year>2002</year>
<volume>30</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1693-700</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<collab>Acute Respiratory Distress Syndrome Network</collab>
<article-title xml:lang=""><![CDATA[Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brower]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[Matthay]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Morris]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Schoenfeld]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Thompson]]></surname>
<given-names><![CDATA[BT]]></given-names>
</name>
<name>
<surname><![CDATA[Wheeler]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[N Engl J Med]]></source>
<year>2000</year>
<volume>342</volume>
<numero>18</numero>
<issue>18</issue>
<page-range>1301-8</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Arancibia]]></surname>
<given-names><![CDATA[HF]]></given-names>
</name>
<name>
<surname><![CDATA[Soto]]></surname>
<given-names><![CDATA[FR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Daño pulmonar inducido por la ventilación mecánica]]></article-title>
<source><![CDATA[Rev Chil Med Inten]]></source>
<year>2010</year>
<volume>25</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>205-10</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amato]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Barbas]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Medeiros]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>1998</year>
<volume>338</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>347-54</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Samary]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Biological impact transpulmonary driving pressure in experimental acute respiratory distress syndrome]]></article-title>
<source><![CDATA[Anesthesiology]]></source>
<year>2015</year>
<volume>123</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>423-33</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amato]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Meade]]></surname>
<given-names><![CDATA[MO]]></given-names>
</name>
<name>
<surname><![CDATA[Slutsky]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Driving pressure and survival in the acute respiratory distress syndrome]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2015</year>
<volume>372</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>747-55</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Loring]]></surname>
<given-names><![CDATA[SH]]></given-names>
</name>
<name>
<surname><![CDATA[Malhotra]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Driving pressure and respiratory mechanics in ARDS]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2015</year>
<volume>372</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>776-7</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bellani]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Laffey]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Pham]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in Intensive Care Units in 50 countries]]></article-title>
<collab>LUNG SAFE Investigators; ESICM Trials Group</collab>
<source><![CDATA[JAMA]]></source>
<year>2016</year>
<volume>315</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>788-800</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guérin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Papazian]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Reignier]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ayzac]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Loundou]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Forel]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials]]></article-title>
<collab>Investigators of the Acurasys and Proseva trials</collab>
<source><![CDATA[Crit Care]]></source>
<year>2016</year>
<volume>20</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>384</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chiumello]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Carlesso]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Brioni]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Cressoni]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Airway driving pressure and lung stress in ARDS patients]]></article-title>
<source><![CDATA[Crit Care]]></source>
<year>2016</year>
<volume>20</volume>
<page-range>276</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Villar]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Martín-Rodríguez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Domínguez-Berrot]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A quantile analysis of plateau and driving pressures: effects on mortality in patients with acute respiratory distress syndrome receiving lung-protective ventilation]]></article-title>
<source><![CDATA[Crit Care Med]]></source>
<year>2017</year>
<volume>45</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>843-50</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Borges]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[Hedenstierna]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Larsson]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Suarez-Sipmann]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Altering the mechanical scenario to decrease the driving pressure]]></article-title>
<source><![CDATA[Crit Care]]></source>
<year>2015</year>
<volume>19</volume>
<page-range>342</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
