A validation study of a continuous automatic measurement of the mechanical power in ARDS patients

The mechanical power (MP) is the energy delivered into the respiratory systemover time. It can be computed as a direct measurement of the inspiratory area of the airway pressure and volume loop during the respiratory cycle or calculated by power equations. The absence of a bedside computation limited its widespread use. Recently, it has been developed an automatic monitoring system inside of a mechanical ventilator. Purpose: Our aim was to investigate the repeatability and the accuracy of the measured MP at different PEEP values and tidal volume compared with the calculated MP. Material and methods: MP was measured and calculated in sedated and paralyzed ARDS patients at low and high tidal volume, at 5-10-15 cmH(2)O of PEEP both in volume and pressure-controlled ventilation. The same measurements were performed twice. Results: Fifty ARDS patients were enrolled. MP was measured and calculated for a total of 300 measurements. The bias and limits of agreement were 0.38 from-1.31 to 2.0 J/min. The measured and calculated MP were similar in each ventilatory condition. Conclusions: The mechanical power measured by a new automatic real time system implemented in a mechanical ventilator was repeatable and accurate compared with the computed one. (C) 2021 Published by Elsevier Inc.

Automated summary

The repeatability and accuracy of measured mechanical power at different PEEP values and tidal volume were investigated, and it was found that the mechanical power measured by the new automatic real-time system within a mechanical ventilator was similar and accurate compared to calculated results.