Elastic static power, its correlation with acute respiratory distress syndrome severity: A Bayesian post-hoc analysis of the Mechanical Power Day cross-sectional trial

Aurio Fajardo-Campoverdi; Alejandro González-Castro; Vicent Modesto I Alapont; Miguel Ibarra-Estrada; Carmen Chica-Meza; Alberto Medina; Patricia Escudero-Acha; Denise Battaglini; Patricia R M Rocco; Chiara Robba; Paolo Pelosi

doi:10.1016/j.medine.2024.502128

Elastic static power, its correlation with acute respiratory distress syndrome severity: A Bayesian post-hoc analysis of the Mechanical Power Day cross-sectional trial

Med Intensiva (Engl Ed). 2024 Dec 30:502128. doi: 10.1016/j.medine.2024.502128. Online ahead of print.

Affiliations

¹ Universidad de la Frontera, Critical Care Unit, Hospital Biprovincial Quillota-Petorca, Quillota, Chile. Electronic address: drauriopiotr@gmail.com.
² Intensive Care Service, Marqués de Valdecilla University Hospital, Santander, Spain.
³ Pediatric Intensive Care Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
⁴ Medicine of the Critically Ill, Civil Hospital Fray Antonio Alcalde and Instituto Jalisciense de Cancerología, Guadalajara, Mexico.
⁵ University of Rosario, Asociación Colombiana de Medicina Crítica y Cuidado Intensivo, Bogotá, Colombia.
⁶ Central University Hospital of Asturias, Oviedo, Spain.
⁷ IRCCS Policlinico San Martino, Genova, Italy.
⁸ Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
⁹ IRCCS Policlinico San Martino, Genova, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.

PMID: 39741096
DOI: 10.1016/j.medine.2024.502128

Abstract

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.

Keywords: ARDS; Elastic static power; Invasive mechanical ventilation; Mechanical power; PEEP; Poder elástico estático; Poder mecánico; SDRA; VALI; Ventilación mecánica invasiva.