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. Ventilator-related causes of lung injury: the mechanical power. Intensive Care Med. 2016 Oct;42(10):1567-1575. PMID 27620287
  2. Rahaman U. Mathematics of Ventilator-induced Lung Injury. Indian J Crit Care Med. 2017 Aug;21(8):521-524. PMID 28904482
  3. Tonetti T, Vasques F, Rapetti F, Maiolo G, Collino F, Romitti F, Camporota L. Driving pressure and mechanical power: new targets for VILI prevention. Ann Transl Med. 2017 Jul;5(14):286. 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. Impact of Different Ventilation Strategies on Driving Pressure, Mechanical Power, and Biological Markers During Open Abdominal Surgery in Rats. Anesth Analg. 2017 Oct;125(4):1364-1374. PMID 28759484
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