Enric Barbeta, Cláudia Barreiros, Edoardo Forin, Amedeo Guzzardella, Anna Motos, Laia Fernández-Barat, Albert Gabarrús, Adrián Ceccato, Ricard Ferrer, Jordi Riera, Oscar Peñuelas, José Ángel Lorente, David de Gonzalo-Calvo, Jessica Gonzalez, Rosario Amaya-Villar, José Manuel Añón, Ana Balan, Carme Barberà, José Barberán, Aaron Blandino, Maria Victoria Boado, Elena Bustamante-Munguira, Jesús Caballero, María Luisa Cantón-Bulnes, Cristina Carbajales, Nieves Carbonell, Mercedes Catalán-González, Nieves Franco, Cristóbal Galbán, Víctor D Gumucio-Sanguino, Maria Del Carmen de la Torre, Emilio Díaz, Ángel Estella, Elena Gallego, José Manuel Gómez, Arturo Huerta, Ruth Noemí Jorge García, Ana Loza-Vázquez, Judith Marin-Corral, María Cruz Martin Delgado, Amalia Martínez, Ignacio Martínez, Juan Lopez, Guillermo M Albaiceta, María Teresa Nieto, Mariana Andrea Novo, Yhivian Peñasco, Felipe Pérez-García, Pilar Ricart, Alejandro Rodríguez, Victor Sagredo, Angel Sánchez-Miralles, Susana Sancho, Ferran Roche-Campo, Lorenzo Socias, Jordi Solé-Violan, Luis Tamayo, José Trenado, Alejandro Úbeda, Luis Jorge Valdivia, Pablo Vidal, Ferran Barbé, Jordi Vallverdú, Antoni Torres
{"title":"Mechanical power is not associated with mortality in COVID-19 mechanically ventilated patients.","authors":"Enric Barbeta, Cláudia Barreiros, Edoardo Forin, Amedeo Guzzardella, Anna Motos, Laia Fernández-Barat, Albert Gabarrús, Adrián Ceccato, Ricard Ferrer, Jordi Riera, Oscar Peñuelas, José Ángel Lorente, David de Gonzalo-Calvo, Jessica Gonzalez, Rosario Amaya-Villar, José Manuel Añón, Ana Balan, Carme Barberà, José Barberán, Aaron Blandino, Maria Victoria Boado, Elena Bustamante-Munguira, Jesús Caballero, María Luisa Cantón-Bulnes, Cristina Carbajales, Nieves Carbonell, Mercedes Catalán-González, Nieves Franco, Cristóbal Galbán, Víctor D Gumucio-Sanguino, Maria Del Carmen de la Torre, Emilio Díaz, Ángel Estella, Elena Gallego, José Manuel Gómez, Arturo Huerta, Ruth Noemí Jorge García, Ana Loza-Vázquez, Judith Marin-Corral, María Cruz Martin Delgado, Amalia Martínez, Ignacio Martínez, Juan Lopez, Guillermo M Albaiceta, María Teresa Nieto, Mariana Andrea Novo, Yhivian Peñasco, Felipe Pérez-García, Pilar Ricart, Alejandro Rodríguez, Victor Sagredo, Angel Sánchez-Miralles, Susana Sancho, Ferran Roche-Campo, Lorenzo Socias, Jordi Solé-Violan, Luis Tamayo, José Trenado, Alejandro Úbeda, Luis Jorge Valdivia, Pablo Vidal, Ferran Barbé, Jordi Vallverdú, Antoni Torres","doi":"10.1186/s13613-025-01430-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The relative contribution of the different components of mechanical power to mortality is a subject of debate and has not been studied in COVID-19. The aim of this study is to evaluate both the total and the relative impact of each of the components of mechanical power on mortality in a well-characterized cohort of patients with COVID-19-induced acute respiratory failure undergoing invasive mechanical ventilation. This is a secondary analysis of the CIBERESUCICOVID project, a multicenter observational cohort study including fifty Spanish intensive care units that included COVID-19 mechanically ventilated patients between February 2020 and December 2021. We examined the association between mechanical power and its components (elastic static, elastic dynamic, total elastic and resistive power) with 90-day mortality after adjusting for confounders in seven hundred ninety-nine patients with COVID-19-induced respiratory failure undergoing invasive mechanical ventilation.</p><p><strong>Results: </strong>At the initiation of mechanical ventilation, the PaO<sub>2</sub>/FiO<sub>2</sub> ratio was 106 (78; 150), ventilatory ratio was 1.69 (1.40; 2.05), and respiratory system compliance was 35.7 (29.2; 44.5) ml/cmH<sub>2</sub>O. Mechanical power at the initiation of mechanical ventilation was 24.3 (18.9; 29.6) J/min, showing no significant changes after three days. In multivariable regression analyses, mechanical power and its components were not associated with 90-day mortality at the start of mechanical ventilation. After three days, total elastic and elastic static power were associated with higher 90-day mortality, but this relationship was also found for positive end-expiratory pressure.</p><p><strong>Conclusions: </strong>Neither mechanical power nor its components were independently associated with mortality in COVID-19-induced acute respiratory failure at the start of MV. Nevertheless, after three days, static elastic power and total elastic power were associated with lower odds of survival. Positive end-expiratory pressure and plateau pressure, however, captured this risk in a similar manner.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"15 1","pages":"27"},"PeriodicalIF":5.7000,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Intensive Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13613-025-01430-6","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The relative contribution of the different components of mechanical power to mortality is a subject of debate and has not been studied in COVID-19. The aim of this study is to evaluate both the total and the relative impact of each of the components of mechanical power on mortality in a well-characterized cohort of patients with COVID-19-induced acute respiratory failure undergoing invasive mechanical ventilation. This is a secondary analysis of the CIBERESUCICOVID project, a multicenter observational cohort study including fifty Spanish intensive care units that included COVID-19 mechanically ventilated patients between February 2020 and December 2021. We examined the association between mechanical power and its components (elastic static, elastic dynamic, total elastic and resistive power) with 90-day mortality after adjusting for confounders in seven hundred ninety-nine patients with COVID-19-induced respiratory failure undergoing invasive mechanical ventilation.
Results: At the initiation of mechanical ventilation, the PaO2/FiO2 ratio was 106 (78; 150), ventilatory ratio was 1.69 (1.40; 2.05), and respiratory system compliance was 35.7 (29.2; 44.5) ml/cmH2O. Mechanical power at the initiation of mechanical ventilation was 24.3 (18.9; 29.6) J/min, showing no significant changes after three days. In multivariable regression analyses, mechanical power and its components were not associated with 90-day mortality at the start of mechanical ventilation. After three days, total elastic and elastic static power were associated with higher 90-day mortality, but this relationship was also found for positive end-expiratory pressure.
Conclusions: Neither mechanical power nor its components were independently associated with mortality in COVID-19-induced acute respiratory failure at the start of MV. Nevertheless, after three days, static elastic power and total elastic power were associated with lower odds of survival. Positive end-expiratory pressure and plateau pressure, however, captured this risk in a similar manner.
期刊介绍：
Annals of Intensive Care is an online peer-reviewed journal that publishes high-quality review articles and original research papers in the field of intensive care medicine. It targets critical care providers including attending physicians, fellows, residents, nurses, and physiotherapists, who aim to enhance their knowledge and provide optimal care for their patients. The journal's articles are included in various prestigious databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, OCLC, PubMed, PubMed Central, Science Citation Index Expanded, SCOPUS, and Summon by Serial Solutions.
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