The Mechanical Power in Patients with Acute Respiratory Distress Syndrome Undergoing Prone Positioning Can Predict Mortality
<b>Background/Objectives:</b> Mechanical power (MP) refers to ventilator-delivered energy to the lungs, which may induce lung injury. We examined the relationship between MP and mortality in patients with acute respiratory distress syndrome (ARDS) who underwent prone positioning. <b&g...
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2025-01-01
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| author | Ko-Wei Chang Shaw-Woei Leu Han-Chung Hu Ming-Cheng Chan Shinn-Jye Liang Kuang-Yao Yang Li-Chung Chiu Wen-Feng Fang Chau-Chyun Sheu Ying-Chun Chien Chung-Kan Peng Ching-Tzu Huang Kuo-Chin Kao |
| author_facet | Ko-Wei Chang Shaw-Woei Leu Han-Chung Hu Ming-Cheng Chan Shinn-Jye Liang Kuang-Yao Yang Li-Chung Chiu Wen-Feng Fang Chau-Chyun Sheu Ying-Chun Chien Chung-Kan Peng Ching-Tzu Huang Kuo-Chin Kao |
| author_sort | Ko-Wei Chang |
| collection | DOAJ |
| description | <b>Background/Objectives:</b> Mechanical power (MP) refers to ventilator-delivered energy to the lungs, which may induce lung injury. We examined the relationship between MP and mortality in patients with acute respiratory distress syndrome (ARDS) who underwent prone positioning. <b>Methods:</b> This multicenter retrospective study included data on all patients admitted to the intensive care units of eight referral hospitals in Taiwan from October 2015 to March 2016, and in Chang Gung Memorial Hospital Linkou branch from January 2017 to October 2023. The data were obtained from the electronic medical records of each hospital by using a standard case report form. MP was calculated as follows: MP (J/min) = 0.098 × VT × RR × (Ppeak − 1/2 × ΔP). <b>Results:</b> We included 135 patients who underwent prone positioning. Among them, 28-day survivors had significantly lower MP (22.6 ± 6.5 vs. 25.3 ± 6.2 J/min, <i>p</i> = 0.024), MP/predicted body weight (PBW) (396.9 ± 118.9 vs. 449.3 ± 118.8 10<sup>−3</sup> J/min/kg, <i>p</i> = 0.018), MP/compliance values (0.8 ± 0.3 vs. 1.1 ± 0.4 J/min/mL/cmH<sub>2</sub>O, <i>p</i> = 0.048) after prone positioning, and significantly lower changes in MP, MP/PBW, and MP/compliance (−0.6 ± 5.7 vs. 2.5 ± 7.4 J/min, <i>p</i> = 0.007; −9.2 ± 97.5 vs. 42.1 ± 127.9 10<sup>−3</sup> J/min/kg, <i>p</i> = 0.010; −0.1 ± 0.3 vs. 0.2 ± 0.3 J/min/mL/cmH<sub>2</sub>O, <i>p</i> < 0.001, respectively). Multivariate Cox regression revealed that the change in MP/compliance (HR: 7.972, <i>p</i> < 0.001) was an independent predictive factor for 28-day mortality. <b>Conclusions:</b> In ARDS patients treated with prone positioning, MP/compliance, and change in MP, MP/PBW, and MP/compliance after prone positioning differed significantly between 28-day survivors and nonsurvivors. Further randomized controlled research is required to elucidate the potential causality of decreased MP and improved clinical outcomes. |
| format | Article |
| id | doaj-art-b045cfad683045c38cee4d0bb7c4ea52 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Diagnostics |
| spelling | doaj-art-b045cfad683045c38cee4d0bb7c4ea522025-01-24T13:28:56ZengMDPI AGDiagnostics2075-44182025-01-0115215810.3390/diagnostics15020158The Mechanical Power in Patients with Acute Respiratory Distress Syndrome Undergoing Prone Positioning Can Predict MortalityKo-Wei Chang0Shaw-Woei Leu1Han-Chung Hu2Ming-Cheng Chan3Shinn-Jye Liang4Kuang-Yao Yang5Li-Chung Chiu6Wen-Feng Fang7Chau-Chyun Sheu8Ying-Chun Chien9Chung-Kan Peng10Ching-Tzu Huang11Kuo-Chin Kao12Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDivision of Critical Care and Respiratory Therapy, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, TaiwanDivision of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, Taichung 404, TaiwanDepartment of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, TaiwanDivision of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, TaiwanDepartment of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan 333, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan<b>Background/Objectives:</b> Mechanical power (MP) refers to ventilator-delivered energy to the lungs, which may induce lung injury. We examined the relationship between MP and mortality in patients with acute respiratory distress syndrome (ARDS) who underwent prone positioning. <b>Methods:</b> This multicenter retrospective study included data on all patients admitted to the intensive care units of eight referral hospitals in Taiwan from October 2015 to March 2016, and in Chang Gung Memorial Hospital Linkou branch from January 2017 to October 2023. The data were obtained from the electronic medical records of each hospital by using a standard case report form. MP was calculated as follows: MP (J/min) = 0.098 × VT × RR × (Ppeak − 1/2 × ΔP). <b>Results:</b> We included 135 patients who underwent prone positioning. Among them, 28-day survivors had significantly lower MP (22.6 ± 6.5 vs. 25.3 ± 6.2 J/min, <i>p</i> = 0.024), MP/predicted body weight (PBW) (396.9 ± 118.9 vs. 449.3 ± 118.8 10<sup>−3</sup> J/min/kg, <i>p</i> = 0.018), MP/compliance values (0.8 ± 0.3 vs. 1.1 ± 0.4 J/min/mL/cmH<sub>2</sub>O, <i>p</i> = 0.048) after prone positioning, and significantly lower changes in MP, MP/PBW, and MP/compliance (−0.6 ± 5.7 vs. 2.5 ± 7.4 J/min, <i>p</i> = 0.007; −9.2 ± 97.5 vs. 42.1 ± 127.9 10<sup>−3</sup> J/min/kg, <i>p</i> = 0.010; −0.1 ± 0.3 vs. 0.2 ± 0.3 J/min/mL/cmH<sub>2</sub>O, <i>p</i> < 0.001, respectively). Multivariate Cox regression revealed that the change in MP/compliance (HR: 7.972, <i>p</i> < 0.001) was an independent predictive factor for 28-day mortality. <b>Conclusions:</b> In ARDS patients treated with prone positioning, MP/compliance, and change in MP, MP/PBW, and MP/compliance after prone positioning differed significantly between 28-day survivors and nonsurvivors. Further randomized controlled research is required to elucidate the potential causality of decreased MP and improved clinical outcomes.https://www.mdpi.com/2075-4418/15/2/158mechanical powerprone positioningacute respiratory distress syndrome |
| spellingShingle | Ko-Wei Chang Shaw-Woei Leu Han-Chung Hu Ming-Cheng Chan Shinn-Jye Liang Kuang-Yao Yang Li-Chung Chiu Wen-Feng Fang Chau-Chyun Sheu Ying-Chun Chien Chung-Kan Peng Ching-Tzu Huang Kuo-Chin Kao The Mechanical Power in Patients with Acute Respiratory Distress Syndrome Undergoing Prone Positioning Can Predict Mortality Diagnostics mechanical power prone positioning acute respiratory distress syndrome |
| title | The Mechanical Power in Patients with Acute Respiratory Distress Syndrome Undergoing Prone Positioning Can Predict Mortality |
| title_full | The Mechanical Power in Patients with Acute Respiratory Distress Syndrome Undergoing Prone Positioning Can Predict Mortality |
| title_fullStr | The Mechanical Power in Patients with Acute Respiratory Distress Syndrome Undergoing Prone Positioning Can Predict Mortality |
| title_full_unstemmed | The Mechanical Power in Patients with Acute Respiratory Distress Syndrome Undergoing Prone Positioning Can Predict Mortality |
| title_short | The Mechanical Power in Patients with Acute Respiratory Distress Syndrome Undergoing Prone Positioning Can Predict Mortality |
| title_sort | mechanical power in patients with acute respiratory distress syndrome undergoing prone positioning can predict mortality |
| topic | mechanical power prone positioning acute respiratory distress syndrome |
| url | https://www.mdpi.com/2075-4418/15/2/158 |
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