Comprehensive study of mechanical power in controlled mechanical ventilation : Prevalence of elevated mechanical power and component analysis
Copyright © 2023 Elsevier España, S.L.U. and SEMICYUC. All rights reserved..
OBJECTIVE: To determine the prevalence of elevated mechanical power (MP) values (>17J/min) used in routine clinical practice.
DESIGN: Observational, descriptive, cross-sectional, analytical, multicenter, international study conducted on November 21, 2019, from 8:00 AM to 3:00 PM. NCT03936231.
SETTING: One hundred thirty-three Critical Care Units.
PATIENTS: Patients receiving invasive mechanical ventilation for any cause.
INTERVENTIONS: None.
MAIN VARIABLES OF INTEREST: Mechanical power.
RESULTS: A population of 372 patients was analyzed. PM was significantly higher in patients under pressure-controlled ventilation (PC) compared to volume-controlled ventilation (VC) (19.20±8.44J/min vs. 16.01±6.88J/min; p<0.001), but the percentage of patients with PM>17J/min was not different (41% vs. 35%, respectively; p=0.382). The best models according to AICcw expressing PM for patients in VC are described as follows: Surrogate Strain (Driving Pressure) + PEEP+Surrogate Strain Rate (PEEP/Flow Ratio) + Respiratory Rate. For patients in PC, it is defined as: Surrogate Strain (Expiratory Tidal Volume/PEEP) + PEEP+Surrogate Strain Rate (Surrogate Strain/Ti) + Respiratory Rate+Expiratory Tidal Volume+Ti.
CONCLUSIONS: A substantial proportion of mechanically ventilated patients may be at risk of experiencing elevated levels of mechanical power. Despite observed differences in mechanical power values between VC and PC ventilation, they did not result in a significant disparity in the prevalence of high mechanical power values.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
Medicina intensiva - 48(2024), 3 vom: 02. März, Seite 155-164 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
González-Castro, Alejandro [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 04.03.2024 Date Revised 03.04.2024 published: Print-Electronic ClinicalTrials.gov: NCT03936231 Citation Status MEDLINE |
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| doi: |
10.1016/j.medine.2023.11.004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364875232 |
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| 100 | 1 | |a González-Castro, Alejandro |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comprehensive study of mechanical power in controlled mechanical ventilation |b Prevalence of elevated mechanical power and component analysis |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 04.03.2024 | ||
| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT03936231 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier España, S.L.U. and SEMICYUC. All rights reserved. | ||
| 520 | |a OBJECTIVE: To determine the prevalence of elevated mechanical power (MP) values (>17J/min) used in routine clinical practice | ||
| 520 | |a DESIGN: Observational, descriptive, cross-sectional, analytical, multicenter, international study conducted on November 21, 2019, from 8:00 AM to 3:00 PM. NCT03936231 | ||
| 520 | |a SETTING: One hundred thirty-three Critical Care Units | ||
| 520 | |a PATIENTS: Patients receiving invasive mechanical ventilation for any cause | ||
| 520 | |a INTERVENTIONS: None | ||
| 520 | |a MAIN VARIABLES OF INTEREST: Mechanical power | ||
| 520 | |a RESULTS: A population of 372 patients was analyzed. PM was significantly higher in patients under pressure-controlled ventilation (PC) compared to volume-controlled ventilation (VC) (19.20±8.44J/min vs. 16.01±6.88J/min; p<0.001), but the percentage of patients with PM>17J/min was not different (41% vs. 35%, respectively; p=0.382). The best models according to AICcw expressing PM for patients in VC are described as follows: Surrogate Strain (Driving Pressure) + PEEP+Surrogate Strain Rate (PEEP/Flow Ratio) + Respiratory Rate. For patients in PC, it is defined as: Surrogate Strain (Expiratory Tidal Volume/PEEP) + PEEP+Surrogate Strain Rate (Surrogate Strain/Ti) + Respiratory Rate+Expiratory Tidal Volume+Ti | ||
| 520 | |a CONCLUSIONS: A substantial proportion of mechanically ventilated patients may be at risk of experiencing elevated levels of mechanical power. Despite observed differences in mechanical power values between VC and PC ventilation, they did not result in a significant disparity in the prevalence of high mechanical power values | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Mechanical power | |
| 650 | 4 | |a Mechanical ventilation | |
| 650 | 4 | |a Strain | |
| 650 | 4 | |a Strain rate | |
| 650 | 4 | |a Ventilación mecánica | |
| 700 | 1 | |a Medina Villanueva, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Escudero-Acha, Patricia |e verfasserin |4 aut | |
| 700 | 1 | |a Fajardo Campoverdi, Aurio |e verfasserin |4 aut | |
| 700 | 1 | |a Gordo Vidal, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Martin-Loeches, Ignacio |e verfasserin |4 aut | |
| 700 | 1 | |a Rocha, Angelo Roncalli |e verfasserin |4 aut | |
| 700 | 1 | |a Romero, Marta Costa |e verfasserin |4 aut | |
| 700 | 1 | |a Hernández López, Marianela |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrando, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Protti, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Modesto I Alapont, Vicent |e verfasserin |4 aut | |
| 700 | 0 | |a Mechanical Power Day Group |e verfasserin |4 aut | |
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