Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts
Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts
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DOI：
10.1007/s00134-018-5375-6
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发表时间：
2018-11-01
影响因子：
38.9
通讯作者：
Schultz, Marcus J.
中科院分区：
文献类型：
--
作者：
Serpa Neto, Ary;Deliberato, Rodrigo Octavio;Schultz, Marcus J.
目的机械功率（MP）可以统一已知的与呼吸机相关的肺损伤的发展变量。本研究的目的是检查MP和危重患者接受有创通气至少48 h. MethodsThis的死亡率之间的关联存储在MIMIC-III和eICU的数据库中的数据进行分析。纳入接受有创通气至少48小时的危重患者。关注的风险敞口为MP。主要结果是在医院mortality. Results 8207例患者的数据进行了分析。第二个24小时内的中位MP在MIMIC-III中为21.4（16.2-28.1）J/min，在eICU中为16.0（11.7-22.1）J/min。MP与院内死亡率独立相关[每增加5 J/min的比值比（OR）1.06（95%置信区间（CI）1.01-1.11）; MIMIC-III中p=0.021，eICU中为1.10（1.02-1.18）; p=0.010]。MP还与ICU死亡率、30天死亡率、无呼吸机天数、ICU和住院时间相关。即使在低潮气量下，高MP也与院内死亡率相关[OR 1.70（1.32-2.18）; p
PurposeMechanical power (MP) may unify variables known to be related to development of ventilator-induced lung injury. The aim of this study is to examine the association between MP and mortality in critically ill patients receiving invasive ventilation for at least 48h.MethodsThis is an analysis of data stored in the databases of the MIMIC-III and eICU. Critically ill patients receiving invasive ventilation for at least 48h were included. The exposure of interest was MP. The primary outcome was in-hospital mortality.ResultsData from 8207 patients were analyzed. Median MP during the second 24h was 21.4 (16.2-28.1) J/min in MIMIC-III and 16.0 (11.7-22.1) J/min in eICU. MP was independently associated with in-hospital mortality [odds ratio per 5J/min increase (OR) 1.06 (95% confidence interval (CI) 1.01-1.11); p=0.021 in MIMIC-III, and 1.10 (1.02-1.18); p=0.010 in eICU]. MP was also associated with ICU mortality, 30-day mortality, and with ventilator-free days, ICU and hospital length of stay. Even at low tidal volume, high MP was associated with in-hospital mortality [OR 1.70 (1.32-2.18); p