Replay - Mechanical power and the role of adaptive modes in lung protective ventilation

Mechanical ventilation is life sustaining but may also lead to damage of the

lungs when stress and strain induce a process known as ventilator-induced

lung injury (VILI) (1-2). Mechanical power, which is calculated by combining

plateau pressure, respiratory rate, flow and volume, may be a predictor of lung

injury(3-4). Reducing the applied mechanical power in ventilation may play a role

in lung protective ventilation and by reducing VILI.

This lecture will cover:

• The basics of mechanical power
• The different types of mechanical power which can contribute to lung damage
• The potential benefits of mechanical power and why is this interesting for lung protective ventilation
• Modes of ventilation which are optimized on mechanical power and lung protective ventilation
• Preliminary results of recent research

Speaker: Ehab G. Daoud MD, FACP, FCCP

Associate professor of medicine JABSOM, University of Hawaii

President of the Society of Mechanical Ventilation

Editor in Chief of the Journal of Mechanical Ventilation

References:

1. Kneyber MC, Zhang H, Slutsky AS. Ventilator-induced lung injury. Similarity and differences between children and adults. Am J Respir Crit Care Med. 2014 Aug 1;190(3):258-65. doi: 10.1164/rccm.201401-0168CP. PMID: 25003705; PMCID: PMC4896812.

2. Nieman, Gary & Satalin, Joshua & Andrews, Penny & Habashi, Nader & Gatto, Louis. (2016). Lung stress, strain, and energy load: engineering concepts to understand the mechanism of ventilator-induced lung injury (VILI). Intensive Care Medicine Experimental. 4. 10.1186/ s40635-016-0090-5.

3. Zhang, Z., Zheng, B., Liu, N. et al. Mechanical power normalized to predicted body weight as a predictor of mortality in patients with acute respiratory distress syndrome. Intensive Care Med 45, 856–864 (2019).

4. Yucai Hong, Lin Chen, Qing Pan, Huiqing Ge, Lifeng Xing, Zhongheng Zhang, Individualized Mechanical power-based ventilation strategy for acute respiratory failure formalized by finite mixture modeling and dynamic treatment regimen, EClinicalMedicine, Volume 36, 2021, 100898, ISSN 2589-5370