학술논문

Bedside calculation of mechanical power during volume- and pressure-controlled mechanical ventilation
Document Type
article
Source
Critical Care, Vol 24, Iss 1, Pp 1-8 (2020)
Subject
Mechanical power
Mechanical ventilation
Ventilator-induced lung injury
Acute respiratory distress syndrome
Lung protective ventilation
Acute respiratory failure
Medical emergencies. Critical care. Intensive care. First aid
RC86-88.9
Language
English
ISSN
1364-8535
Abstract
Abstract Background Mechanical power (MP) is the energy delivered to the respiratory system over time during mechanical ventilation. Our aim was to compare the currently available methods to calculate MP during volume- and pressure-controlled ventilation, comparing different equations with the geometric reference method, to understand whether the easier to use surrogate formulas were suitable for the everyday clinical practice. This would warrant a more widespread use of mechanical power to promote lung protection. Methods Forty respiratory failure patients, sedated and paralyzed for clinical reasons, were ventilated in volume-controlled ventilation, at two inspiratory flows (30 and 60 L/min), and pressure-controlled ventilation with a similar tidal volume. Mechanical power was computed both with the geometric method, as the area between the inspiratory limb of the airway pressure and the volume, and with two algebraic methods, a comprehensive and a surrogate formula. Results The bias between the MP computed by the geometric method and by the comprehensive algebraic method during volume-controlled ventilation was respectively 0.053 (0.77, − 0.81) J/min and − 0.4 (0.70, − 1.50) J/min at low and high flows (r 2 = 0.96 and 0.97, p