The Relationship Between Mechanical Power Normalized to Dynamic Lung Compliance and Weaning Outcomes in Mechanically Ventilated Patients

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Aug 22

PMID 39173059

Authors

Yao Yan

Zhiqiang Du

Haoran Chen

Suxia Liu

Xiaobing Chen

Xiaomin Li

Yongpeng Xie

Affiliations

Soon will be listed here.

Abstract

Background: Prolonged mechanical ventilation is associated with an increased risk of mortality in these patients. However, there exists a significant clinical need for novel indicators that can complement traditional weaning evaluation methods and effectively guide ventilator weaning.

Objectives: To investigate the specific relationship between mechanical power normalized to dynamic lung compliance (Cdyn-MP) and weaning outcomes in patients on mechanical ventilation for more than 24 hours, as well as those who underwent a T-tube weaning strategy.

Methods: A retrospective cohort study was conducted using the Medical Information Mart for Intensive Care-IV v1.0 database (MIMIC-IV v1.0). Patients who received invasive mechanical ventilation for more than 24 hours and underwent a T-tube ventilation strategy for weaning were enrolled. Patients were divided into two groups based on their weaning outcome: weaning success and failure. Ventilation parameter data were collected every 4 hours during the first 24 hours before the first spontaneous breathing trial (SBT).

Results: Of all the 3,695 patients, 1,421 (38.5%) experienced weaning failure. Univariate logistic regression analysis revealed that the risk of weaning failure increased as the Cdyn-MP level rose (OR 1.34, 95% CI 1.31-1.38, P<0.001). After adjusting for age, body mass index, disease severity, and pre-weaning disease status, patients with high Cdyn-MP quartiles in the 4 hours prior to the SBT had a significantly greater risk of weaning failure than those with low Cdyn-MP quartiles (odds ratio 10.37, 95% CI 7.56-14.24). These findings were robust and consistent in both subgroup and sensitivity analyses.

Conclusion: The increased Cdyn-MP before SBT was independently associated with a higher risk of weaning failure in mechanically ventilated patients. Cdyn-MP has the potential to be a useful indicator for guiding the need for ventilator weaning and complementing traditional weaning evaluation methods.

Citing Articles

The association of ventilator mechanical power with weaning outcomes in intensive care unit patients: a narrative review.

Harder J, Molter J, Nugent K J Thorac Dis. 2025; 17(1):487-495.

PMID: 39975757 PMC: 11833598. DOI: 10.21037/jtd-24-1381.

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