Author, as appears in the article.: Manrique, Sara; Ruiz-Botella, Manuel; Murillo, Natalia; Canelles, Sandra; Victoria, Ivan David; Samper, Manuel Andres; Plans, Oriol; Claverias, Laura; Magret, Monica; Gordo, Federico; Roca, Oriol; Bodi, Maria
Department: Enginyeria Química
URV's Author/s: Manrique Moreno, Sara / Ruiz Botella, Manuel
Keywords: Aged Clinical information syste Clinical information system Covid-19 Critical illness Describe Failure Female Hospital mortality Humans Induced lung injury Inspiratory flow Intensive care units Length of stay Lower tidal volumes Male Mechanical power Mechanical ventilation Middle aged Protective mechanical ventilation Pulmonary complications Respiration, artificial Respiratory-distress-syndrome Retrospective studies Sars-cov-2 Sars-cov2 Spain Strai Ventilation-induced lung injury Ventilator-induced lung injury
Abstract: Background Over the past decade, numerous studies on potential factors contributing to ventilation-induced lung injury have been carried out. Mechanical power has been pointed out as the parameter that encloses all ventilation-induced lung injury-contributing factors. However, studies conducted to date provide data regarding mechanical power during the early hours of mechanical ventilation that may not accurately reflect the impact of power throughout the period of mechanical ventilatory support on intensive care unit mortality. Methods Retrospective observational study conducted at a single center in Spain. Patients admitted to the intensive care unit, > o = 18 years of age, and ventilated for over 24 h were included. We extracted the mechanical power values throughout the entire mechanical ventilation in controlled modes period from the clinical information system every 2 min. First, we calculate the cutoff-point for mechanical power beyond which there was a greater change in the probability of death. After, the sum of time values above the safe cut-off point was calculated to obtain the value in hours. We analyzed if the number of hours the patient was under ventilation with a mechanical power above the safe threshold was associated with intensive care unit mortality, invasive mechanical ventilation days, and intensive care unit length of stay. We repeated the analysis in different subgroups based on the degree of hypoxemia and in patients with SARS CoV-2 pneumonia. Results The cut-off point of mechanical power at with there is a higher increase in intensive care unit mortality was 18 J/min. The greater the number of hours patients were under mechanical power > 18 J/min the higher the intensive care unit mortality in all the study population, in patients with SARS CoV-2 pneumonia and in mild to moderate hypoxemic respiratory failure. The risk of death in the intensive care unit increases 0.1% for each hour with mechanical power exceeding 18 J/min. The number of hours with mechanical power > 18 J/min also affected the days of invasive mechanical ventilation and intensive care unit length of stay. Conclusions The number of hours with mechanical power > 18 J/min is associated with mortality in the intensive care unit in critically ill patients. Continuous monitoring of mechanical power in controlled modes using an automated clinical information system could alert the clinician to this risk.
Thematic Areas: Ciências biológicas iii Enfermagem Farmacia General medicine Medicina i Medicina ii Medicina iii Medicine (all) Medicine (miscellaneous) Medicine, research & experimental Química Saúde coletiva
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: sara.manrique@estudiants.urv.cat manuel.ruiz@urv.cat
Record's date: 2024-10-26
Papper version: info:eu-repo/semantics/publishedVersion
Papper original source: European Journal Of Medical Research. 29 (1): 491-
APA: Manrique, Sara; Ruiz-Botella, Manuel; Murillo, Natalia; Canelles, Sandra; Victoria, Ivan David; Samper, Manuel Andres; Plans, Oriol; Claverias, Laura; (2024). Impact of mechanical power on ICU mortality in ventilated critically ill patients: a retrospective study with continuous real-life data. European Journal Of Medical Research, 29(1), 491-. DOI: 10.1186/s40001-024-02082-1
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Entity: Universitat Rovira i Virgili
Journal publication year: 2024
Publication Type: Journal Publications
Repositori URV