Introduction:

Efficient ventilation is essential in COVID-19 but an appropriate driving pressure (DP) and mechanical power (PM) must be applied.

Objective:

To evaluate the association of driving pressure and mechanical power with mortality in patients with severe-critical COVID-19.

Material and methods:

Observational, cross-sectional, analytical, retrospective study. Through bivariate and multivariate statistical analysis, it was determined if the DP and PM are associated with mortality, considering significant a p < 0.05.

Results:

137 patients with severe-critical COVID-19, mean age 55.8 ± 16.4 years, were included. The comorbidities were arterial hypertension 85 (62%), obesity 62 (45.3%) and diabetes mellitus 50 (36.5%). Mortality was 71 (52.3%). In severe illness, the DP was 14.2 ± 5.1 cmH2O and in critical illness it was 11.3 ± 5.0 cmH2O (p = 0.001). The mean PM values with severe COVID-19 were 19.5 ± 19.3 J/min and in critical COVID-19 they were 29.1 ± 27.6 J/min (p = 0.026). The AUC of DP to predict mortality was 0.740 (p < 0.001) and of PM 0.569 (p = 0.171). In the multivariate analysis, the factors independently associated with mortality were age (ORa = 1.041, CI95% 1.015-1.068, p = 0.002) and DP (ORa = 1.207, CI95% 1.101-1.322, p < 0.001).

Conclusion:

Driving pressure is an independent and significant predictor of mortality in patients with severe-critical COVID-19.