P-SILI occurs when high respiratory drive generates large transpulmonary pressure swings, causing regional overstretch and lung injury even without positive pressure ventilation, particularly in ARDS and severe pneumonia.

How is P-SILI risk assessed clinically?

Clinical signs of high respiratory drive (accessory muscle use, tracheal tug, paradoxical breathing), high respiratory rate, and esophageal pressure swings >15 cmH2O suggest significant P-SILI risk.

P-SILI Risk Index — Patient Self-Inflicted Lung Injury

Assess the risk of Patient Self-Inflicted Lung Injury (P-SILI) during spontaneous breathing by evaluating respiratory drive, effort, and transpulmonary pressure swings in patients with acute respiratory failure.

Use the full interactive calculator below, or

P-SILI Risk Index — Patient Self-Inflicted Lung Injury

Frequently Asked Questions

What causes P-SILI?

How is P-SILI risk assessed clinically?