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Minerva anestesiologica · Jan 2022
Simplified calculation of mechanical power for pressure controlled ventilation in Covid-19 ARDS patients.
- Sinan Aşar, Özlem Acicbe, Mehmet S Sabaz, Evrim Kucur Tülübaş, Gülsüm O Hergünsel, Zafer Çukurova, Emral Canan, and Nahit Çakar.
- Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey - sinan.asaras@gmail.com.
- Minerva Anestesiol. 2022 Jan 1; 88 (1-2): 42-50.
BackgroundMechanical power (MP) is a promising tool for guidance of lung protective ventilation. Different equations have been proposed to calculate MP in pressure control ventilation (PCV). The aim of this study is to introduce an easy to use MP equation MP
pcv(m-simpl) and compare it to an equation proposed by Van der Meijden et al. (MPpcv ) which considered as the reference equation in PCV.MethodsVentilatory parameters of 206 Covid-19 ARDS patients recorded between 24-72 hours after admission to intensive care unit. The PCV data from these patients were retrospectively investigated. MP in PCV was calculated with a modified equation (MPpcv(m-simpl) ) derived from the equation (MPpcv ) of Van der Meijden et al.: 0.098xRRx∆Vx(PEEP+∆Pinsp - 1). The results from MPpcv(slope) , MPpcv(simpl) , andpcv(m-simpl) were compared to MPpcv at 15 cmH2 O ∙ s/L inspiratory resistance levels by univariable regression and Bland-Altman analysis.ResultsInspiratory resistance levels at 15 cmH2 O s/L was found to be correlated between the power values calculated by MPpcv(simpl) /MPpcv(m-simpl) and the MPpcv(slope) /MPpcv based on univariable logistic regression (R2≥98) analyses. In the comparison of all patients average MP values computed by the MPpcv(m-simpl) equation and the MPpcv reference equation. Bland-Altman analysis mean difference and p values at 15 cmH2 O s/L inspiratory resistance values (J/min) were found to be MPpcv(m-simpl) vs MPpcv =-0,04 (P=0.014); MPpcv(slope) vs. MPpcv =0.63 (P<0.0001); MPpcv(simpl) vs. MPpcv =0.64 J/min (P<0.0001), respectively.ConclusionsThe results of this study confirmed that the MPpcv(m-simpl) equation can be used easily to calculate MP at bedside in pressure control ventilated COVID-19 ARDS patients.Notes
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