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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versión impresa ISSN 2448-8909
Resumen
TURRUBIATES HERNANDEZ, Theno Alexandro et al. Association and predictive value of the mechanical power-lung compliance index with free days off mechanical ventilation in patients with COVID-19 in an intensive care unit. Med. crít. (Col. Mex. Med. Crít.) [online]. 2022, vol.36, n.2, pp.91-97. Epub 18-Nov-2022. ISSN 2448-8909. https://doi.org/10.35366/104870.
Introduction:
Mechanical power (MP) is associated with mortality and must be adjusted to the pulmonary characteristics in COVID-19 patients.
Material and methods:
Observational, retrospective, analytical study from September 2020-February 2021. Ventilation parameters and ROC curve analysis and Poisson regression models for OR. Primary objective was to determine the association between the PM/Cest index and free days of mechanical ventilation (FDMV).
Results:
43 patients were included. It was divided into survivors (n = 25, 58.1%) and non-survivors (n = 18, 41.9%). Median FDMV was chosen with the IMV parameters. The initial MP/Cest index ABC 0.73 [95% CI (0.58-0.88), p = 0.008], cut-off point of 0.90 J/min/mL/cmH2O. The multivariate Poisson regression showed the initial MP/Cest index OR 0.18 [95% CI (0.03-0.98), p = 0.047].
Discussion:
Coppola et al. documented in patients with non-COVID-19 ARDS, the absolute MP value did not demonstrate significance; when adjusted to Cest, it was independent for mortality.
Conclusions:
The MP/Cest index at baseline was significantly and independently associated with FDMV in COVID-19. Cut-off point of 0.9 J/min/mL/cmH2O with better sensitivity and specificity to predict FDMV and this could reduce mortality.
Palabras llave : Mechanical power; lung compliance; COVID-19; acute respiratory distress syndrome; free days from mechanical ventilation.