Respiratory failure & ventilation
High Mechanical Power and Driving Pressures are Associated With Postoperative Respiratory Failure Independent From Patients’ Respiratory System Mechanics*
Authors' conclusion
High mechanical power and ΔP are associated with PRF independent of patient's baseline respiratory system compliance.
Study context
- Population
- Adults undergoing GA, academic hospital in New England, 2008–20204,030 (4.1%) developed postoperative respiratory failure (PRF)
- Participants
- 97,555 adults
- Exposure
- High vs low mechanical power; high vs low ΔP
- Outcome
- PRF (reintubation or unplanned noninvasive ventilation within seven days)
- Follow-up
- Seven days
Methodological detailsexact matching by baseline respiratory system compliance, single academic hospital, Large variability in applied ventilatory parameters, dependent on the anesthesia provider
- Exact matching by baseline respiratory system compliance
- Single academic hospital
- Large variability in applied ventilatory parameters, dependent on the anesthesia provider
Main finding
As reported in the abstract
PRF, adjusted analyses
Adjusted odds ratio (95% CI)P value
High mechanical power vs Low mechanical power
1.37(1.25–1.50)
P < 0.001High ΔP vs Low ΔP
1.45(1.31–1.60)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| PRF after exact matching by baseline respiratory system compliance (63,612 mechanical power cohort; 53,260 ΔP cohort)High mechanical power vs Low mechanical power · matched cohort | 1.30 (1.17–1.45) | P < 0.001 | |
| PRF after exact matching by baseline respiratory system compliance (63,612 mechanical power cohort; 53,260 ΔP cohort)High ΔP vs Low ΔP · matched cohort | 1.28 (1.12–1.46) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
| Outcome | High mechanical power | Low mechanical power | High ΔP | Low ΔP | SDiff |
|---|---|---|---|---|---|
| Mechanical power in matched cohortHigh mechanical power vs Low mechanical power | 9.4 ([ ] 2.4) J/min | 4.9 ([ ] 1.3) J/min | — not stated in the abstract | — not stated in the abstract | −2.33 |
| ΔP in matched cohortHigh ΔP vs Low ΔP | — not stated in the abstract | — not stated in the abstract | 19.3 ([ ] 4.1) cm H 2 O | 11.9 ([ ] 2.1) cm H 2 O | −2.27 |
— not stated in the abstract
- PRF after exact matching by baseline respiratory system compliance (63,612 mechanical power cohort; 53,260 ΔP cohort) — Identical baseline standardized respiratory system compliance after matching (SDiff)
- 0.00
Original publication
High Mechanical Power and Driving Pressures are Associated With Postoperative Respiratory Failure Independent From Patients’ Respiratory System Mechanics*. Crit Care Med. Published 11 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →