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Abstract
Mechanical ventilation is a lifesaving intervention that may also induce further lung injury by exerting excessive mechanical forces on susceptible lung tissue, a phenomenon termed ventilator-induced lung injury (VILI). The concept of mechanical power (MP) aims to unify in one single variable the contribution of the different ventilatory parameters that could induce VILI by measuring the energy transfer to the lung over time. Despite an increasing amount of evidence demonstrating that high MP values can be associated with VILI development in experimental studies, the evidence regarding the association of MP and clinical outcomes remains controversial. In the present review, we describe the different determinants of VILI, the concept and computation of MP, and discuss the experimental and clinical studies related to MP. Currently, due to different limitations, the clinical application of MP is debatable. Further clinical studies are required to enhance our understanding of the relationship between MP and the development of VILI, as well as its potential impact on clinical outcomes.
Footnotes
- Correspondence: L Felipe Damiani PT MSc PhD, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Vicuña Mackena 4860, Santiago, Chile. E-mail: Lfdamiani{at}uc.cl
The authors have disclosed no conflicts of interest.
Dr Damiani presented a version of this paper at the New Horizons Symposium: Changing Concepts in Mechanical Ventilation at AARC Congress 2022, held November 9–12, 2022, in New Orleans, Louisiana.
Dr Damiani acknowledges partial support from Agencia Nacional de Investigacion y Desarrollo, Grant Fondecyt Regular 2022/Folio 1220853. Mr Basoalto acknowledges partial support from CONICYT-PFCHA/Doctorado Nacional 2020-folio 21201751.
- Copyright © 2023 by Daedalus Enterprises
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- Article
- Abstract
- Introduction
- Understanding VILI and the Underlying Determinants in ARDS
- Mechanical Power as a Unifying Concept
- Computation of Mechanical Power
- Association Between Mechanical Power and Lung Injury
- Association Between Mechanical Power and Clinical Outcomes
- Limitations and Future Research
- Summary
- Footnotes
- REFERENCES
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