Medicina intensiva · 2024
Elastic static power, its correlation with acute respiratory distress syndrome severity: A Bayesian post-hoc analysis of the Mechanical Power Day cross-sectional trial.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Fajardo-Campoverdi Aurio, González-Castro Alejandro, Modesto I Alapont Vicent, Ibarra-Estrada Miguel, Chica-Meza Carmen, Medina Alberto, Escudero-Acha Patricia, Battaglini Denise, Rocco Patricia R M, Robba Chiara, Pelosi Paolo
Аннотация
OBJECTIVE: The relationship between different power equations and the severity of acute respiratory distress syndrome (ARDS) remains unclear. This study aimed to evaluate various power equations: total mechanical power, total elastic power (comprising elastic static and elastic dynamic power), and resistive power, in a cohort of mechanically ventilated patients with and without ARDS. Bayesian analysis was employed to refine estimates and quantify uncertainty by incorporating a priori distributions.
DESIGN: A Bayesian post-hoc analysis was conducted on data from the Mechanical Power Day study.
SETTING: 113 intensive care units across 15 countries and 4 continents.
PATIENTS: Adults who received invasive mechanical ventilation in volume-controlled mode, with (mild and moderate/severe ARDS) and without ARDS.
INTERVENTIONS: None.
MAIN VARIABLES OF INTEREST: ARDS, Elastic static power.
RESULTS: Elastic static power was 5.8 J/min (BF: 0.3) in patients with mild ARDS and 7.4 J/min (BF: 0.9) in moderate/severe ARDS patients. Bayesian regression and modeling analysis revealed that elastic static power was independently correlated with mild (a posteriori Mean: 1.3; 95% Credible Interval [Cred. Interval]: 0.2-2.2) and moderate/severe ARDS (a posteriori Mean: 2.8; 95% Cred. Interval: 1.7-3.8) more strongly than other power equations.
CONCLUSIONS: Elastic static power was found to have the strongest correlation with ARDS severity among the power equations studied. Prospective studies are needed to further validate these findings.
DESIGN: A Bayesian post-hoc analysis was conducted on data from the Mechanical Power Day study.
SETTING: 113 intensive care units across 15 countries and 4 continents.
PATIENTS: Adults who received invasive mechanical ventilation in volume-controlled mode, with (mild and moderate/severe ARDS) and without ARDS.
INTERVENTIONS: None.
MAIN VARIABLES OF INTEREST: ARDS, Elastic static power.
RESULTS: Elastic static power was 5.8 J/min (BF: 0.3) in patients with mild ARDS and 7.4 J/min (BF: 0.9) in moderate/severe ARDS patients. Bayesian regression and modeling analysis revealed that elastic static power was independently correlated with mild (a posteriori Mean: 1.3; 95% Credible Interval [Cred. Interval]: 0.2-2.2) and moderate/severe ARDS (a posteriori Mean: 2.8; 95% Cred. Interval: 1.7-3.8) more strongly than other power equations.
CONCLUSIONS: Elastic static power was found to have the strongest correlation with ARDS severity among the power equations studied. Prospective studies are needed to further validate these findings.