• van MeenenDavid M PDMPFrom the Department of Intensive Care (DMPvM, AGA, MTUS, FDS, SMvdH, SN, FP, MJS), Department of Anesthesiology (DMPvM), Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Amsterdam UMC, Location AMC, Amsterdam, Anna Geke Algera, Michiel T U Schuijt, Fabienne D Simonis, Sophia M van der Hoeven, NetoAry SerpaAS, AbreuMarcelo Gama deMG, Paolo Pelosi, Frederique Paulus, Marcus J Schultz, for the NEBULAE , PReVENT , and RELAx investigators .
• From the Department of Intensive Care (DMPvM, AGA, MTUS, FDS, SMvdH, SN, FP, MJS), Department of Anesthesiology (DMPvM), Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Amsterdam UMC, Location AMC, Amsterdam, the Netherlands (MJS), Department of Critical Care Medicine, Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Australia (SN), Pulmonary Engineering Group (MGdA), Department of Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany (MGdA), Department of Intensive Care and Resuscitation (MGdA), Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA (MGdA), Department of Surgical Sciences and Integrated Diagnostics (DISC) (PP), IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy (PP), Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands (FP), Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand (MJS) and Nuffield Department of Medicine, University of Oxford, Oxford, UK (MJS).
• Eur J Anaesthesiol. 2023 Jan 1; 40 (1): 212821-28.

BackgroundThe mechanical power of ventilation (MP) has an association with outcome in invasively ventilated patients with the acute respiratory distress syndrome (ARDS). Whether a similar association exists in invasively ventilated patients without ARDS is less certain.ObjectiveTo investigate the association of mechanical power with mortality in ICU patients without ARDS.DesignThis was an individual patient data analysis that uses the data of three multicentre randomised trials.SettingThis study was performed in academic and nonacademic ICUs in the Netherlands.PatientsOne thousand nine hundred and sixty-two invasively ventilated patients without ARDS were included in this analysis. The median [IQR] age was 67 [57 to 75] years, 706 (36%) were women.Main Outcome MeasuresThe primary outcome was the all-cause mortality at day 28. Secondary outcomes were the all-cause mortality at day 90, and length of stay in ICU and hospital.ResultsAt day 28, 644 patients (33%) had died. Hazard ratios for mortality at day 28 were higher with an increasing MP, even when stratified for its individual components (driving pressure ( P  < 0.001), tidal volume ( P  < 0.001), respiratory rate ( P  < 0.001) and maximum airway pressure ( P  = 0.001). Similar associations of mechanical power (MP) were found with mortality at day 90, lengths of stay in ICU and hospital. Hazard ratios for mortality at day 28 were not significantly different if patients were stratified for MP, with increasing levels of each individual component.ConclusionIn ICU patients receiving invasive ventilation for reasons other than ARDS, MP had an independent association with mortality. This finding suggests that MP holds an added predictive value over its individual components, making MP an attractive measure to monitor and possibly target in these patients.Trial RegistrationClinicalTrials.gov Identifier: NCT02159196, ClinicalTrials.gov Identifier: NCT02153294, ClinicalTrials.gov Identifier: NCT03167580.Copyright © 2022 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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