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. 2025 Feb 25;15(1):27.
doi: 10.1186/s13613-025-01430-6.

Mechanical power is not associated with mortality in COVID-19 mechanically ventilated patients

Enric Barbeta  1   2   3 , Cláudia Barreiros  2 , Edoardo Forin  4 , Amedeo Guzzardella  5 , Anna Motos  1   3 , Laia Fernández-Barat  1   3 , Albert Gabarrús  1   3 , Adrián Ceccato  1   6   7 , Ricard Ferrer  8 , Jordi Riera  8 , Oscar Peñuelas  1   9 , José Ángel Lorente  1   9   10 , David de Gonzalo-Calvo  1   11 , Jessica Gonzalez  1   11 , Rosario Amaya-Villar  12 , José Manuel Añón  1   13 , Ana Balan  14 , Carme Barberà  15 , José Barberán  16 , Aaron Blandino  17   18 , Maria Victoria Boado  19 , Elena Bustamante-Munguira  1   20 , Jesús Caballero  21 , María Luisa Cantón-Bulnes  22 , Cristina Carbajales  23 , Nieves Carbonell  24 , Mercedes Catalán-González  25 , Nieves Franco  26 , Cristóbal Galbán  27 , Víctor D Gumucio-Sanguino  28 , Maria Del Carmen de la Torre  29 , Emilio Díaz  30 , Ángel Estella  31 , Elena Gallego  1   32 , José Manuel Gómez  33 , Arturo Huerta  34 , Ruth Noemí Jorge García  35 , Ana Loza-Vázquez  36 , Judith Marin-Corral  37 , María Cruz Martin Delgado  38 , Amalia Martínez  39 , Ignacio Martínez  40 , Juan Lopez  41 , Guillermo M Albaiceta  1   42 , María Teresa Nieto  43 , Mariana Andrea Novo  44 , Yhivian Peñasco  45 , Felipe Pérez-García  46   47 , Pilar Ricart  48 , Alejandro Rodríguez  49 , Victor Sagredo  50 , Angel Sánchez-Miralles  51 , Susana Sancho  52 , Ferran Roche-Campo  53 , Lorenzo Socias  54 , Jordi Solé-Violan  1   55 , Luis Tamayo  1   56 , José Trenado  57 , Alejandro Úbeda  58 , Luis Jorge Valdivia  59 , Pablo Vidal  60 , Ferran Barbé  1   11 , Jordi Vallverdú  2 , Antoni Torres  61   62   63 ; CIBERESUCICOVID Project investigators (COV20/00110, ISCIII)
Collaborators, Affiliations

Mechanical power is not associated with mortality in COVID-19 mechanically ventilated patients

Enric Barbeta et al. Ann Intensive Care. .

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.

Keywords: COVID-19; Mechanical power; Mechanical ventilation; Respiratory failure.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This is an ancillary analysis of the CIBERESUCICOVID project (NCT04457505). The study was approved by the Institution’s Internal Review Board (Comité Ètic d’Investigació Clínica, Registry number HCB/2020/0370), and informed consent was obtained from either patients or their relatives. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flowchart
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References

    1. The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301–8. 10.1056/NEJM200005043421801. - PubMed
    1. Amato MBP, Meade MO, Slutsky AS, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med. 2015;372:747–55. 10.1056/NEJMsa1410639. - PubMed
    1. Gattinoni L, Marini JJ, Collino F, et al. The future of mechanical ventilation: lessons from the present and the past. Crit Care. 2017;21:1–11. 10.1186/s13054-017-1750-x. - PMC - PubMed
    1. Cressoni M, Gotti M, Chiurazzi C, et al. Mechanical power and development of ventilator-induced lung injury. Anesthesiology. 2016;124:1100–8. 10.1097/ALN.0000000000001056. - PubMed
    1. Serpa Neto A, Deliberato RO, Johnson AEW, et al. Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts. Intensive Care Med. 2018;44:1914–22. 10.1007/s00134-018-5375-6. - PubMed

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