Association between mechanical power and intensive care unit mortality in Korean patients under pressure-controlled ventilation
- Author:
Jae Kyeom SIM
1
;
Sang-Min LEE
;
Hyung Koo KANG
;
Kyung Chan KIM
;
Young Sam KIM
;
Yun Seong KIM
;
Won-Yeon LEE
;
Sunghoon PARK
;
So Young PARK
;
Ju-Hee PARK
;
Yun Su SIM
;
Kwangha LEE
;
Yeon Joo LEE
;
Jin Hwa LEE
;
Heung Bum LEE
;
Chae-Man LIM
;
Won-Il CHOI
;
Ji Young HONG
;
Won Jun SONG
;
Gee Young SUH
Author Information
- Publication Type:Original Article
- From: Acute and Critical Care 2024;39(1):91-99
- CountryRepublic of Korea
- Language:English
- Abstract: Mechanical power (MP) has been reported to be associated with clinical outcomes. Because the original MP equation is derived from paralyzed patients under volume-controlled ventilation, its application in practice could be limited in patients receiving pressure-controlled ventilation (PCV). Recently, a simplified equation for patients under PCV was developed. We investigated the association between MP and intensive care unit (ICU) mortality. Methods: We conducted a retrospective analysis of Korean data from the Fourth International Study of Mechanical Ventilation. We extracted data of patients under PCV on day 1 and calculated MP using the following simplified equation: MPPCV = 0.098 ∙ respiratory rate ∙ tidal volume ∙ (ΔPinsp + positive end-expiratory pressure), where ΔPinsp is the change in airway pressure during inspiration. Patients were divided into survivors and non-survivors and then compared. Multivariable logistic regression was performed to determine association between MPPCV and ICU mortality. The interaction of MPPCV and use of neuromuscular blocking agent (NMBA) was also analyzed. Results: A total of 125 patients was eligible for final analysis, of whom 38 died in the ICU. MPPCV was higher in non-survivors (17.6 vs. 26.3 J/min, P<0.001). In logistic regression analysis, only MPPCV was significantly associated with ICU mortality (odds ratio, 1.090; 95% confidence interval, 1.029–1.155; P=0.003). There was no significant effect of the interaction between MPPCV and use of NMBA on ICU mortality (P=0.579). Conclusions: MPPCV is associated with ICU mortality in patients mechanically ventilated with PCV mode, regardless of NMBA use.
