Department of Anesthesiology and Reanimation, Koç University Hospital, Istanbul, Türkiye.
Department of Anesthesiology and Reanimation, Koç University Hospital, Istanbul, Türkiye -
Minerva Anestesiol. 2023 Jul-Aug;89(7-8):663-670. doi: 10.23736/S0375-9393.23.17080-5. Epub 2023 Apr 20.
Mechanical power (MP) is the amount of energy transferred from the ventilator to the patient within a unit of time. It has been emphasized in ventilation-induced lung injury (VILI) and mortality. However, its measurement and use in clinical practice are challenging. "Electronic recording systems (ERS)" using mechanical ventilation parameters provided by the ventilator can be helpful to measure and record the MP. The MP (J/minutes) formula is 0.098 x tidal volume x respiratory rate x (Ppeak - ½ ∆P), in which ∆P is the driving pressure and Ppeak is the peak pressure. We aimed to define the association between MP values and ICU mortality, mechanical ventilation days, and intensive care unit length of stay (ICU-LOS). The secondary outcome was to determine the most potent or essential component of power in the equation that has a role in mortality.
This retrospective study was performed in two centers (VKV American Hospital and Bakırköy Sadi Konuk Hospital ICUs) that used ERS (Metavision IMDsoft) between 2014 and 2018. We uploaded the power formula (MP (J/minutes)=0.098×VT×RR×(Ppeak - ½ ∆P) to ERS (METAvision, iMDsoft, and Consult Orion Health) and calculated the MP value by using MV parameters automatically sent from the ventilator. (∆P; driving pressure, VT; tidal volume, RR; respiratory rate and Ppeak; peak pressure).
A total of 3042 patients were included in the study. The median value of MP was 11.3 J/min. Mortality in MP<11.3 J/min was 35.4%, and 49.1% in MP>11.3J/min.; P<0.001. Mechanical ventilation days and ICU-LOS were also statistically longer in the MVP>11.3 J/min group.
The first 24 h MP maybe a predictive value for the ICU patients' prognosis. This implies that MP may be used as a decision-making system to define the clinical approach and as a scoring system to predict patient prognosis.
机械功率（MP）是单位时间内从呼吸机传递到患者的能量量。它在呼吸机引起的肺损伤（VILI）和死亡率中得到了强调。然而，其在临床实践中的测量和使用具有挑战性。使用呼吸机提供的机械通气参数的“电子记录系统（ERS）”可以帮助测量和记录 MP。MP（J/min）公式为 0.098 x 潮气量 x 呼吸频率 x（Ppeak - ½ ∆P），其中 ∆P 为驱动压力，Ppeak 为峰值压力。我们旨在定义 MP 值与 ICU 死亡率、机械通气天数和 ICU 住院时间（ICU-LOS）之间的关联。次要结果是确定方程中对死亡率有影响的功率最有效或最基本的组成部分。
这项回顾性研究在两个中心（VKV 美国医院和 Bakırköy Sadi Konuk 医院 ICU）进行，这些中心在 2014 年至 2018 年间使用 ERS（Metavision IMDsoft）。我们将功率公式（MP（J/min）=0.098×VT×RR×（Ppeak - ½ ∆P）上传到 ERS（METAvision、iMDsoft 和 Consult Orion Health），并使用呼吸机自动发送的 MV 参数计算 MP 值。（∆P；驱动压力，VT；潮气量，RR；呼吸频率和 Ppeak；峰值压力）。
共有 3042 名患者纳入研究。MP 的中位数为 11.3 J/min。MP<11.3 J/min 时的死亡率为 35.4%，MP>11.3J/min 时为 49.1%；P<0.001。MP>11.3 J/min 组的机械通气天数和 ICU-LOS 也明显更长。
前 24 小时的 MP 可能是 ICU 患者预后的预测值。这意味着 MP 可用于作为决策系统来定义临床方法，以及作为评分系统来预测患者预后。
