Mechanical ventilation in SARS-CoV-2 patients: state of art

Mechanical power measurement during mechanical ventilation of SARS-CoV-2 critically ill patients. A cohort study

Introduction: The ventilator-induced lung injury (VILI) depends on the amount of energy per minute transferred by the ventilator to the lung measured in Joules, which is called mechanical power. Mechanical power is a development variable probably associated with outcomes in ventilated patients. Objective: To describe the value of mechanical power in patients with SARS-CoV-2 infection and ventilated for other causes and its relationship between days of mechanical ventilation, length of stay in the intensive care unit (ICU), and mortality. Methods: A multicenter, analytical, observational cohort study was conducted in patients with SARS-CoV-2 infection who required invasive mechanical ventilation and patients ventilated for other causes for more than 24 hours. Results: The cohort included 91 patients on mechanical ventilation in three tertiary care centers in the city of Pereira, Colombia. The average value of the mechanical power found was 22.7 ± 1 Joules/min. In the subgroup of patients with SARS-CoV-2 infection, the value of mechanical power was higher 26.8 ± 9 than in the subgroup of patients without a diagnosis of SARS-CoV-2 infection 18.2 ± 1 (p <0.001). Conclusion: Mechanical power is an important variable to consider during the monitoring of mechanical ventilation. This study found an average value of mechanical power of 22.7 ± 1 Joules/min, being higher in patients with SARS-CoV-2 infection related to longer days of mechanical ventilation and a longer stay in the ICU.