Impact of mechanical power on ICU mortality in ventilated critically ill patients: a retrospective study with continuous real-life data
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Le résumé fourni par la source
BACKGROUND: Over the past decade, numerous studies on potential factors contributing to ventilation-induced lung injury have been carried out. Mechanical power has been pointed out as the parameter that encloses all ventilation-induced lung injury-contributing factors. However, studies conducted to date provide data regarding mechanical power during the early hours of mechanical ventilation that may not accurately reflect the impact of power throughout the period of mechanical ventilatory support on intensive care unit mortality. METHODS: Retrospective observational study conducted at a single center in Spain. Patients admitted to the intensive care unit, > o = 18 years of age, and ventilated for over 24 h were included. We extracted the mechanical power values throughout the entire mechanical ventilation in controlled modes period from the clinical information system every 2 min. First, we calculate the cutoff-point for mechanical power beyond which there was a greater change in the probability of death. After, the sum of time values above the safe cut-off point was calculated to obtain the value in hours. We analyzed if the number of hours the patient was under ventilation with a mechanical power above the safe threshold was associated with intensive care unit mortality, invasive mechanical ventilation days, and intensive care unit length of stay. We repeated the analysis in different subgroups based on the degree of hypoxemia and in patients with SARS CoV-2 pneumonia. RESULTS: The cut-off point of mechanical power at with there is a higher increase in intensive care unit mortality was 18 J/min. The greater the number of hours patients were under mechanical power > 18 J/min the higher the intensive care unit mortality in all the study population, in patients with SARS CoV-2 pneumonia and in mild to moderate hypoxemic respiratory failure. The risk of death in the intensive care unit increases 0.1% for each hour with mechanical power exceeding 18 J/min. The number of hours with mechanical power > 18 J/min also affected the days of invasive mechanical ventilation and intensive care unit length of stay. CONCLUSIONS: The number of hours with mechanical power > 18 J/min is associated with mortality in the intensive care unit in critically ill patients. Continuous monitoring of mechanical power in controlled modes using an automated clinical information system could alert the clinician to this risk.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Impact of mechanical power on ICU mortality in ventilated critically ill patients: a retrospective study with continuous real-life data
- Date Crossref
- 07/10/2024
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Institut de Recerca Biomèdica Catalunya Sud pays non établi dans la noticeStructure de recherche
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Hospital Universitari Joan XXIII de Tarragona pays non établi dans la noticeÉtablissement de santé
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Universitat Rovira i Virgili pays non établi dans la noticeUniversité ou école supérieure
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Hospital Universitario del Henares Critical Care Department pays non établi dans la noticeÉtablissement de santé
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Instituto de Salud Carlos III Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES) pays non établi dans la noticeOrganisation à but non lucratif
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Centro de Investigación Biomédica en Red de Enfermedades Respiratorias pays non établi dans la noticeStructure de recherche
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Corporació Sanitària Parc Taulí pays non établi dans la noticeInstitution
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Hospital Universitario Joan XXIII Critical Care Department pays non établi dans la noticeÉtablissement de santé
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Instituto de Investigación Sanitaria Pere i Virgili pays non établi dans la noticeStructure de recherche
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Rovira i Virgili University pays non établi dans la noticeUniversité ou école supérieure
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Departament of Chemical Engineering pays non établi dans la noticeInstitution
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Parc Taulí Hospital Universitari Critical Care Department pays non établi dans la noticeÉtablissement de santé
Institut de Recerca Biomèdica Catalunya Sud, Hospital Universitari Joan XXIII de Tarragona et Universitat Rovira i Virgili, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.