The mechanical power in neurocritical care patients: is it useful?

Journal of Clinical Monitoring and Computing - Tập 36 - Trang 1581-1583 - 2022
D. Chiumello1,2,3, S. Coppola1
1Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
2Department of Health Sciences, University of Milan, Milan, Italy
3Coordinated Research Center on Respiratory Failure, University of Milan, Milan, Italy

Tóm tắt

Patients with acute brain injury have been excluded in the majority of the randomized clinical trials which evaluated a lung protective strategy in patients with acute respiratory failure. It remains unclear if low tidal volume, higher PEEP levels and recruitment maneuvers by increasing both the intracranial and intrathoracic pressure and by leading to a permissible hypercapnia could furthermore deteriorate the acute brain injury and the final outcome. Mechanical power has been associated with the outcome in ARDS patients without brain injury. Jiang et al. demonstrated in neurocritical patients that non-survivors had a higher mechanical power compared to survivors. Mechanical power was associated with an increase in intensive care mortality risk and also to an enhanced risk of hospital mortality, prolonged intensive care length of stay and fewer ventilatory free days; in addition, the mechanical power could better predict mortality compared to the Glasgow Coma Scale.

Tài liệu tham khảo

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