Mechanical Power: A New Concept in Mechanical Ventilation

• Published in: The American journal of the medical sciences 2021-12, Vol.362 (6), p.537-545
• Main Authors: Paudel, Robin, Trinkle, Christine A., Waters, Christopher M., Robinson, Lauren E., Cassity, Evan, Sturgill, Jamie L., Broaddus, Richard, Morris, Peter E.
• Format: Article
• Language: English
• Subjects: Acute respiratory distress syndromes; Humans; Mechanical energy; Mechanical power; Mechanical ventilator; Prospective Studies; Respiration, Artificial - adverse effects; Respiratory Distress Syndrome; Tidal Volume; Ventilator induced lung injury; Ventilator-Induced Lung Injury - etiology; Ventilator-Induced Lung Injury - prevention & control
• ISSN: 0002-9629; 1538-2990; 1538-2990
• DOI: 10.1016/j.amjms.2021.09.004

Mechanical ventilation is a potentially life-saving therapy for patients with acute lung injury, but the ventilator itself may cause lung injury. Ventilator-induced lung injury (VILI) is sometimes an unfortunate consequence of mechanical ventilation. It is not clear however how best to minimize VILI through adjustment of various parameters including tidal volume, plateau pressure, driving pressure, and positive end expiratory pressure (PEEP). No single parameter provides a clear indication for onset of lung injury attributable exclusively to the ventilator. There is currently interest in quantifying how static and dynamic parameters contribute to VILI. One concept that has emerged is the consideration of the amount of energy transferred from the ventilator to the respiratory system per unit time, which can be quantified as mechanical power. This review article reports on recent literature in this emerging field and future roles for mechanical power assessments in prospective studies.