AI Article Synopsis
- The study aimed to evaluate how common elevated mechanical power (MP) values are in critically ill patients on invasive mechanical ventilation.
- It analyzed data from 372 patients across 133 Critical Care Units, revealing higher MP in pressure-controlled (PC) ventilation compared to volume-controlled (VC) ventilation, but no significant difference in the prevalence of high MP (>17J/min) between the two methods.
- The findings suggest a notable number of patients may face the risk of high MP, indicating a need for careful monitoring in ventilated patients, despite the lack of a significant difference in high MP prevalence based on the ventilation type.
Article Abstract
Objective: To determine the prevalence of elevated mechanical power (MP) values (>17J/min) used in routine clinical practice.
Design: Observational, descriptive, cross-sectional, analytical, multicenter, international study conducted on November 21, 2019, from 8:00 AM to 3:00 PM. NCT03936231.
Setting: One hundred thirty-three Critical Care Units.
Patients: Patients receiving invasive mechanical ventilation for any cause.
Interventions: None.
Main Variables Of Interest: Mechanical power.
Results: A population of 372 patients was analyzed. PM was significantly higher in patients under pressure-controlled ventilation (PC) compared to volume-controlled ventilation (VC) (19.20±8.44J/min vs. 16.01±6.88J/min; p<0.001), but the percentage of patients with PM>17J/min was not different (41% vs. 35%, respectively; p=0.382). The best models according to AICcw expressing PM for patients in VC are described as follows: Surrogate Strain (Driving Pressure) + PEEP+Surrogate Strain Rate (PEEP/Flow Ratio) + Respiratory Rate. For patients in PC, it is defined as: Surrogate Strain (Expiratory Tidal Volume/PEEP) + PEEP+Surrogate Strain Rate (Surrogate Strain/Ti) + Respiratory Rate+Expiratory Tidal Volume+Ti.
Conclusions: A substantial proportion of mechanically ventilated patients may be at risk of experiencing elevated levels of mechanical power. Despite observed differences in mechanical power values between VC and PC ventilation, they did not result in a significant disparity in the prevalence of high mechanical power values.
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| http://dx.doi.org/10.1016/j.medine.2023.11.004 | DOI Listing |
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