Fig. 4

Factors contributing to respiratory drive heterogeneity in acute respiratory failure. Inflammation and associated vascular permeability are key determinants of respiratory drive in critical illness that may explain why some critically ill patients experience refractory high drive despite accounting for other clinically observable factors, including even deep sedation. High drive in turn may cause patient self-inflicted lung injury (P-SILI) that increases inflammatory signaling, creating a positive feedback loop. Blue denotes chemoreceptor inputs. Green denotes pulmonary mechanoreceptor inputs. Purple denotes supratentorial inputs. Red denotes inflammatory input