Anest. intenziv. Med. 2023;34(4):165-171 | DOI: 10.36290/aim.2023.065

Mechanical power of mechanical ventilation: unnecessary or necessary parameter?Review Article

Burša F., Frelich M., Sklienka P., Jor O., Máca J.

Klinika anesteziologie, resuscitace a intenzivní medicíny Fakultní nemocnice Ostrava a Lékařské fakulty Ostravské univerzity, Ostrava

Mechanical ventilation (MV) is one of the established methods of organ support in intensive care units. In patients with lung disease, especially in its more severe forms, MV can act with such forces that it can lead to further damage to the diseased lungs. Mechanical energy (ME) is a parameter representing the total energy that the MV exerts on the lungs (or lungs, airways, and chest). Higher ME values are associated with a higher risk of ventilator-induced lung injury (VILI). ME can be calculated from ventilation parameters using equations, some of which allow calculation directly at the patient's bedside on a regular calculator. By adjusting individual parameters, we can then reduce the ME to reduce the risk of VILI. From the formulas, it is also possible to derive how the individual parameters contribute to the overall ME, and we can thus decide which parameter should be adjusted. This review article provides a comprehensive view of the current knowledge of ME as a ventilatory parameter associated with the risk of VILI. Equations for calculating ME for individual ventilation modes are presented here, with a critical assessment of the accuracy of individual calculation options and the use of the ME concept in routine daily practice at the patient's bed on MV.

Keywords: mechanical ventilation, adult respiratory distress syndrome, ventilator­‑induced lung injuries.

Received: September 11, 2023; Revised: November 15, 2023; Accepted: November 30, 2023; Prepublished online: December 12, 2023; Published: December 15, 2023  Show citation