Analysis of the correlation between elastic power and 28-day prognosis in ARDS patients : a multicentre, prospective, observational study
10.3760/cma.j.issn.1671-0282.2023.10.018
- VernacularTitle:弹力功与ARDS患者28 d预后相关性分析：一项多中心、前瞻性、观察性研究
- Author:
Yongpeng XIE
1
;
Xiqing YAO
;
Panpan REN
;
Yao YAN
;
Ming HUA
;
Xiaobao GU
;
Yanli WANG
;
Xiaomin LI
Author Information
1. 连云港市第一人民医院急危重症医学部，连云港 222000
- Keywords:
ARDS;
Mechanical ventilation;
Elastic power;
Mechanical power;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2023;32(10):1397-1404
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the relevance of a new comprehensive respiratory mechanics parameter, elastic power, to the 28-day prognosis of ARDS patients.Methods:Patients with ARDS hospitalized for at least 48 h with invasive mechanical ventilation in five intensive care units in three local hospitals in Lianyungang City from June 2018 to June 2022 were included in the study. Their baseline data and respiratory mechanics parameters were collected. Elastic power, mechanical power, driving pressure and lung compliance are calculated according to the corresponding formulae. The prognostic risk factors of ARDS patients were analysed using COX multi-factor regression, and the predictive value of EP/Cst on the 28-day prognosis of ARDS patients was evaluated based on ROC curve analysis and Kaplan-Meier survival curve.Results:There was no significantly difference in tidal volume and PEEP settings between the patients in the ARDS survivor and death groups ( P> 0.05). However, the differences in respiratory rate, plateau pressure, driving pressure, lung compliance, mechanical work, elastic work, EP/cst and MP/cst between the two groups were significantly different (all P< 0.01). Multifactorial COX regression analysis showed that EP/cst ( HR=1.211, 95% CI:1.091-1.323) and RR ( HR=1.209, 95% CI:1.046-1.339) were strongly associated with a more severe degree of illness and a worse prognosis in ARDS. And the cumulative survival rate at 28 d was significantly lower in the high Cst-EP group than in the low Cst-EP group (50.00% vs. 82.40%, P < 0.01). Conclusions:The new respiratory mechanics parameters EP and EP/Cst can assess the severity of ARDS with a good predictive effect on patient prognosis at 28 days.
