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Dynamic mechanical power at the bedside: A validation study in volume-controlled and pressure-controlled ventilation
Furkan Tontu1, Dicle Birtane2, Yasemin Çelik2
1Department of Anesthesiology and Reanimation, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
Journal of Critical Care
|October 31, 2025
Summary
Dynamic mechanical power (MPdyn) accurately estimates geometric mechanical power (MPgeo) in ARDS patients, offering a reliable bedside tool for calculating ventilator-induced lung injury risk.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
- Biomedical Engineering
Background:
- Mechanical power (MP) is crucial for understanding ventilator-induced lung injury (VILI) and mortality.
- Accurate bedside calculation of MP remains a significant clinical challenge.
- The dynamic mechanical power equation (MPdyn) offers a simplified approach needing validation against the geometric standard (MPgeo).
Purpose of the Study:
- To validate the dynamic mechanical power equation (MPdyn) against the geometric gold standard (MPgeo).
- To assess MPdyn accuracy across volume-controlled (VCV) and pressure-controlled ventilation (PCV) modes.
- To evaluate performance at different inspiratory-to-expiratory (I:E) ratios (1:2 and 1:1).
Main Methods:
- Prospective observational study involving 36 adult ARDS patients in a tertiary ICU.
- MPgeo derived from pressure-volume loops using Python-based image processing (OpenCV, NumPy, PIL).
- MPdyn calculated using a validated formula; agreement assessed via linear regression and Bland-Altman analysis.
Main Results:
- MPdyn showed strong correlation with MPgeo across all ventilation modes and I:E ratios (R² ≥ 0.97).
- Minimal bias observed: 0.15 J/min (0.8%) for VCV 1:2 to 0.52 J/min (3.4%) for PCV 1:1.
- Standard deviation of bias consistently remained below 0.5 J/min.
Conclusions:
- MPdyn demonstrates high agreement with MPgeo in both VCV and PCV.
- Supports MPdyn as a simple, reliable, and bedside-applicable tool for mechanical power calculation in ARDS.
- Facilitates improved management of VILI risk at the patient's bedside.
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