Correlation of mechanical power and outcome in critically ill patients in Indian population: A prospective...

Mechanical ventilation is a cornerstone in managing acute respiratory failure, yet, it can lead to ventilator-induced lung injury. This study investigated the relationship between mechanical power (MP) and 28-day mortality in critically ill patients undergoing mechanical ventilation.

A single-centre, prospective observational study was conducted, involving 102 mechanically ventilated patients in a tertiary care intensive care unit (ICU). Patient characteristics, ventilator parameters, and clinical scores {Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA)} were recorded. MP was calculated at 24, 48, and 72 hours, and its correlation with mortality and other clinical outcomes was analysed using logistic regression.

The cohort had a median age of 40.5 years, with a mortality rate of 37.3% within 28 days. Higher baseline MP values (23.90 J/min vs. 19.0 J/min, P = 0.008) were observed in non-survivors. MP demonstrated strong correlations with driving pressure and plateau pressure (r = 0.79 to 0.86, P < 0.001). MP was measured at 24, 48, and 72 hours after ICU admission and demonstrated increasing predictive validity for 28-day mortality (Hazard ratio of 1.05, 1.09, and 1.11, respectively). The receiver operating characteristic curve supported this trend, with area under the curve values rising from 0.633 at 24 hours to 0.708 at 48 hours and 0.747 at 72 hours.

This study highlights MP as a critical factor in assessing mortality risk in mechanically ventilated patients. Elevated MP correlates with increased mortality. Monitoring MP in addition to already established parameters can predict the outcome of patients on mechanical ventilation. Future research should explore MP and its implications for ventilation practices in diverse patient populations.