Reply to Bihari et al. : Alveolar Collapse Is a Threat in Injured Lungs, but What About the Airway Opening Pressure?

This document is a reply to Bihari et al.'s interest in a recent publication on the impact of limiting lung overdistention or collapse when mechanically ventilating injured lungs. The authors agree that it is important to assess both alveolar collapse and airway closure in this scenario. Airway closure is a phenomenon where the airways, but not the alveoli, are collapsed until a minimum pressure is reached, known as the airway opening pressure (AOP). The authors measured the AOP in their experiments and found that it was low, ruling out the hypothesis that AOP would have affected their results. They acknowledge that there are differences between pigs and humans, but the physiological responses observed in the study provide valuable insights for clinical practice. [Extracted from the article]