Mechanical power

Mechanical power is a medical term which is a measure of the amount of energy imparted to a patient by a mechanical ventilator.[1][2][3][4][5]

Respiratory therapist examining a mechanically ventilated patient on an Intensive Care Unit. The more time a patient spends exposed to the forces applied to them by a mechanical ventilator, the higher the risk of suffering a ventilator-associated lung injury.

While in many cases mechanical ventilation is a life-saving or life-preserving intervention, it also has the potential to cause harm to the patient via ventilator-associated lung injury. A number of stresses may be induced by the ventilator on the patient's lung. These include barotrauma caused by pressure, volutrauma caused by distension of the lungs, rheotrauma caused by fast-flowing delivery of gases and atelectotrauma resulting from repeated collapse and re-opening of the lung.

The purpose of mechanical power is to provide a quantity which can account for all of these stresses and therefore predict the amount of lung injury which is likely to be seen in the patient.

References

  1. Gattinoni, L; Tonetti, T; Cressoni, M; Cadringher, P; Herrmann, P; Moerer, O; Protti, A (Oct 2016). "Ventilator-related causes of lung injury: the mechanical power". Intensive Care Med. 42 (10): 1567–1575. doi:10.1007/s00134-016-4505-2. PMID 27620287.
  2. Rahaman, U (2017). "Mathematics of Ventilator-induced Lung Injury". Indian J Crit Care Med. 21 (8): 521–524. doi:10.4103/ijccm.IJCCM_411_16. PMC 5588487. PMID 28904482.
  3. Tonetti, T; Vasques, F; Rapetti, F; Maiolo, G; Collino, F; Romitti, F; Camporota, L (Jul 2017). "Driving pressure and mechanical power: new targets for VILI prevention". Ann Transl Med. 5 (14): 286. doi:10.21037/atm.2017.07.08. PMC 5537108. PMID 28828361.
  4. Gattinoni, Luciano; Marini, John J.; Collino, Francesca; Maiolo, Giorgia; Rapetti, Francesca; Tonetti, Tommaso; Vasques, Francesco; Quintel, Michael (12 July 2017). "The future of mechanical ventilation: lessons from the present and the past". Critical Care. 21 (1): 183. doi:10.1186/s13054-017-1750-x. PMC 5508674. PMID 28701178.
  5. Maia, LA; Samary, CS; Oliveira, MV; Santos, CL; Huhle, R; Capelozzi, VL (Oct 2017). "Impact of Different Ventilation Strategies on Driving Pressure, Mechanical Power, and Biological Markers During Open Abdominal Surgery in Rats". Anesth Analg. 125 (4): 1364–1374. doi:10.1213/ANE.0000000000002348. PMID 28759484.
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