The Association Between Mechanical Power and Postoperative Pulmonary Complications: A Critical Narrative Review of Clinical Controversies.

Postoperative pulmonary complications (PPCs) are a highly prevalent and serious issue following general anesthesia that significantly affect patient prognosis. Ventilator-induced lung injury is a key contributor to PPCs. Traditional lung-protective ventilation strategies primarily focus on single static parameters such as tidal volume and positive end-expiratory pressure, which have inherent limitations. As a comprehensive energetic parameter, mechanical power (MP) integrates multiple parameters, including tidal volume, pressure, and flow into the total energy delivered to the respiratory system per unit time. This review aims to elaborate on the basic concept and calculation methods of MP, with a particular focus on the current state of research regarding its association with PPCs. Current evidence is insufficient to demonstrate that MP is independently associated with an increased risk of PPCs. In current clinical practice; however, it may be a reasonable trade-off strategy for high-risk patients to use MP as a supplement to traditional static parameters, and to curb its excessive elevation through the optimization of flow rate and respiratory frequency. Future high-quality, standardized studies are needed to clarify the causal relationship between MP and PPCs and to explore its potential value in guiding individualized lung-protective ventilation strategies.