A validation study of a continuous automatic measurement of the mechanical power in ARDS patients

J Crit Care. 2022 Feb:67:21-25. doi: 10.1016/j.jcrc.2021.09.009. Epub 2021 Oct 6.

Abstract

The mechanical power (MP) is the energy delivered into the respiratory system over time. It can be computed as a direct measurement of the inspiratory area of the airway pressure and volume loop during the respiratory cycle or calculated by "power equations". The absence of a bedside computation limited its widespread use. Recently, it has been developed an automatic monitoring system inside of a mechanical ventilator.

Purpose: Our aim was to investigate the repeatability and the accuracy of the measured MP at different PEEP values and tidal volume compared with the calculated MP.

Material and methods: MP was measured and calculated in sedated and paralyzed ARDS patients at low and high tidal volume, at 5-10-15 cmH2O of PEEP both in volume and pressure-controlled ventilation. The same measurements were performed twice.

Results: Fifty ARDS patients were enrolled. MP was measured and calculated for a total of 300 measurements. The bias and limits of agreement were 0.38 from -1.31 to 2.0 J/min. The measured and calculated MP were similar in each ventilatory condition.

Conclusions: The mechanical power measured by a new automatic real time system implemented in a mechanical ventilator was repeatable and accurate compared with the computed one.

Keywords: ARDS; Mechanical power; VILI; Ventilatory management.

MeSH terms

  • Humans
  • Lung
  • Respiration, Artificial
  • Respiratory Distress Syndrome* / therapy
  • Tidal Volume
  • Ventilators, Mechanical