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Title: Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts
Authors: Ary Serpa Neto
Rodrigo Octavio Deliberato
Alistair E.W. Johnson
Lieuwe D. Bos
Pedro Amorim
Silvio Moreto Pereira
Denise Carnieli Cazati
Ricardo L. Cordioli
Thiago Domingos Correa
Tom J. Pollard
Guilherme P.P. Schettino
Karina T. Timenetsky
Leo A. Celi
Paolo Pelosi
Marcelo Gama de Abreu
Marcus J. Schultz
Ospedale Policlinico San Martino
Beth Israel Deaconess Medical Center
Dresden University Faculty of Medicine and University Hospital Carl Gustav Carus
Università degli Studi di Genova
Massachusetts Institute of Technology
Hospital Israelita Albert Einstein
Mahidol University
Amsterdam UMC - University of Amsterdam
Keywords: Medicine
Issue Date: 1-Nov-2018
Citation: Intensive Care Medicine. Vol.44, No.11 (2018), 1914-1922
Abstract: © 2018, Springer-Verlag GmbH Germany, part of Springer Nature and ESICM. Purpose: Mechanical power (MP) may unify variables known to be related to development of ventilator-induced lung injury. The aim of this study is to examine the association between MP and mortality in critically ill patients receiving invasive ventilation for at least 48 h. Methods: This is an analysis of data stored in the databases of the MIMIC–III and eICU. Critically ill patients receiving invasive ventilation for at least 48 h were included. The exposure of interest was MP. The primary outcome was in-hospital mortality. Results: Data from 8207 patients were analyzed. Median MP during the second 24 h was 21.4 (16.2–28.1) J/min in MIMIC-III and 16.0 (11.7–22.1) J/min in eICU. MP was independently associated with in-hospital mortality [odds ratio per 5 J/min increase (OR) 1.06 (95% confidence interval (CI) 1.01–1.11); p = 0.021 in MIMIC-III, and 1.10 (1.02–1.18); p = 0.010 in eICU]. MP was also associated with ICU mortality, 30-day mortality, and with ventilator-free days, ICU and hospital length of stay. Even at low tidal volume, high MP was associated with in-hospital mortality [OR 1.70 (1.32–2.18); p < 0.001] and other secondary outcomes. Finally, there is a consistent increase in the risk of death with MP higher than 17.0 J/min. Conclusion: High MP of ventilation is independently associated with higher in-hospital mortality and several other outcomes in ICU patients receiving invasive ventilation for at least 48 h.
ISSN: 14321238
Appears in Collections:Scopus 2018

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