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Calculation of mechanical power for pressure-controlled ventilation

  • Tobias BecherEmail author
  • M. van der Staay
  • D. Schädler
  • I. Frerichs
  • N. Weiler
Letter

Dear Editor,

The mechanical power (MP) is a single variable encompassing important ventilator-related causes of lung injury that can be calculated using a set of parameters routinely measured during volume-controlled ventilation (VCV) [1]. A recent analysis of two large databases revealed that high MP is independently associated with mortality in critically ill patients on mechanical ventilation [2]. As the equation for calculation of MP used for these analyses is based on the assumption of VCV with a linear rise of airway pressure (Paw) during inspiration, it is not suitable for calculating MP during pressure-controlled ventilation (PCV) [3]. Here, we describe two equations for estimating MP during PCV and assess their validity in patients ventilated with this mode.

We retrospectively analyzed PCV data of patients enrolled in two previously published studies [4, 5]. We excluded datasets obtained during assisted spontaneous breathing and during VCV.

Under the assumption of an ideal...

Notes

Compliance with ethical standards

Conflicts of interest

Tobias Becher and Dirk Schädler received lecture fees from Drägerwerk AG & Co. KGaA (Lübeck, Germany). Matthias van der Staay is an employee of imt and works for imtmedical, Buchs, Switzerland. The other authors report no conflicts of interest.

Supplementary material

134_2019_5636_MOESM1_ESM.doc (201 kb)
Supplementary material 1 (DOC 201 kb)

References

  1. 1.
    Gattinoni L, Tonetti T, Cressoni M et al (2016) Ventilator-related causes of lung injury: the mechanical power. Intensive Care Med 42:1567–1575CrossRefGoogle Scholar
  2. 2.
    Neto AS, Deliberato RO, Johnson AW et al (2018) Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts. Intensive Care Med 44:1914–1922CrossRefGoogle Scholar
  3. 3.
    Zhao Z, Frerichs I, He H et al (2019) The calculation of mechanical power is not suitable for intra-patient monitoring under pressure-controlled ventilation. Intensive Care Med.  https://doi.org/10.1007/s00134-019-05536-x Google Scholar
  4. 4.
    Pulletz S, Adler A, Kott M et al (2012) Regional lung opening and closing pressures in patients with acute lung injury. J Crit Care 27(27):323.e11–323.e18CrossRefGoogle Scholar
  5. 5.
    Becher T, Bui S, Zick G et al (2014) Assessment of respiratory system compliance with electrical impedance tomography using a positive end-expiratory pressure wave maneuver during pressure support ventilation: a pilot clinical study. Crit Care 18:679CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology and Intensive Care MedicineUniversity Medical Centre Schleswig–HolsteinKielGermany
  2. 2.IMT AGBuchsSwitzerland

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