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Medicina crítica (Colegio Mexicano de Medicina Crítica)

versão impressa ISSN 2448-8909

Resumo

ROSAS SANCHEZ, Karina; GUTIERREZ ZARATE, Damián  e  CERON DIAZ, Ulises W. Association and predictive value of mechanical power with ventilator-free days. Med. crít. (Col. Mex. Med. Crít.) [online]. 2017, vol.31, n.6, pp.320-325. ISSN 2448-8909.

Introduction:

Pulmonary disease attributable to mechanical ventilation (MV) has been named ventilator-associated lung injury (VALI). The mechanical power formula (MP) brings together the main variables that determine VALI development. It analyzes the correlation between MP and ventilator-free days (VFD), as well as the predictive capacity for VFD.

Material and methods:

We studied 40 patients admitted to the intensive care unit (ICU) and who met the inclusion criteria. Demographic, clinical and laboratory data were collected. MP calculation was performed in the first 24 hours of ICU stay and we determined VFD, ICU stay and ICU mortality. The Spearman’s rho test was performed to determine the correlation between MP and VFD; we performed the bi-varied and later multivariate binary regression analysis. To evaluate the predictive capacity of the variables that were independently related, we compared the areas under the curve (AUC) in the receiver operating characteristics (COR) curve.

Results

MP and VFD have an inverse correlation with intermediate magnitude. They were independently associated: MP OR 2.07, 95% CI (1.10-4.09), p = 0.01, respiratory rate OR 1.5, 95% CI (1.05-2.3), p = 0.04 and Tv/ kg (≤ 8.2 mL) OR 0.01, 95% CI (0.001-0.10), p = 0.002. MP (AUC) 0.75, 95% CI (0.59-0.90), p = 0.007, respiratory rate (ABC) 0.71, 95% CI (0.54-0.88), p = 0.01 and Tv/kg (ABC) 0.92, IC (0.83-1.0), p = 0.001.

Conclusion:

MP and VFD have inverse correlation, with ability for predicting VFD, with a cutoff point of 13 Joules/min.

Palavras-chave : Mechanical power; ventilator-free days; respiratory rate; tidal volume.

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