机械功率在急性呼吸窘迫综合征患者和手术室机械通气患者中的应用_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

刘红梅 ,  余海

四川大学华西医院麻醉科（四川成都 610041）;

Corresponding author：

余海, Email: yuhaishan117@yahoo.com

Keywords：

DOI：

10.7507/1671-6205.202110006

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Citation： 刘红梅, 余海. 机械功率在急性呼吸窘迫综合征患者和手术室机械通气患者中的应用. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(1): 61-65. doi: 10.7507/1671-6205.202110006 Copy

1.	Vasques F, Duscio E, Cipulli F, et al. Determinants and prevention of ventilator-induced lung injury. Crit Care Clin, 2018, 34(3): 343-356.
2.	Gattinoni L, Quintel M. How ARDS should be treated. Crit Care, 2016, 20: 86.
3.	Agostini P, Cieslik H, Rathinam S, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors?. Thorax, 2010, 65(9): 815-818.
4.	O'Gara B, Talmor D. Perioperative lung protective ventilation. BMJ, 2018, 362: k3030.
5.	Tonetti T, Cressoni M, Collino F, et al. Volutrauma, atelectrauma, and mechanical power. Crit Care Med, 2017, 45(3): e327-e328.
6.	Protti A, Cressoni M, Santini A, et al. Lung stress and strain during mechanical ventilation: any safe threshold?. Am J Respir Crit Care Med, 2011, 183(10): 1354-1362.
7.	Gattinoni L, Tonetti T, Cressoni M, et al. Ventilator-related causes of lung injury: the mechanical power. Intensive Care Med, 2016, 42(10): 1567-1575.
8.	Tonetti T, Vasques F, Rapetti F, et al. Driving pressure and mechanical power: new targets for VILI prevention. Ann Transl Med, 2017, 5(14): 286.
9.	Cressoni M, Gotti M, Chiurazzi C, et al. Mechanical power and development of ventilator-induced lung injury. Anesthesiology, 2016, 124(5): 1100-1108.
10.	孙秀梅, 王玉妹, 杨燕琳, 等. 机械功率在呼吸机相关性肺损伤的研究现状. 中华危重病急救医学, 2019, 31(12): 1549-1551.
11.	Maia LA, Samary CS, Oliveira MV, et al. Impact of different ventilation strategies on driving pressure, mechanical power, and biological markers during open abdominal surgery in rats. Anesth Analg, 2017, 125(4): 1364-1374.
12.	Santos RS, Maia LA, Oliveira MV, et al. Biologic impact of mechanical power at high and low tidal volumes in experimental mild acute respiratory distress syndrome. Anesthesiology, 2018, 128(6): 1193-1206.
13.	Marini JJ, Rocco PRM, Gattinoni L. Static and dynamic contributors to ventilator-induced lung injury in clinical practice. Pressure, energy, and power. Am J Respir Crit Care Med, 2020, 201(7): 767-774.
14.	Marini JJ, Rocco PRM. Which component of mechanical power is most important in causing VILI?. Crit Care, 2020, 24(1): 39.
15.	Acute Respiratory Distress Syndrome Network; Brower RG, Matthay MA, Morris A, et al. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med, 2000, 342(18): 1301-1308.
16.	Serpa Neto A, Cardoso SO, Manetta JA, et al. Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis. JAMA, 2012, 308(16): 1651-1659.
17.	Futier E, Constantin JM, Paugam-Burtz C, et al. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery. N Engl J Med, 2013, 369(5): 428-437.
18.	Mini G, Ray BR, Anand RK, et al. Effect of driving pressure-guided positive end-expiratory pressure (PEEP) titration on postoperative lung atelectasis in adult patients undergoing elective major abdominal surgery: a randomized controlled trial. Surgery, 2021, 170(1): 277-283.
19.	Sahetya SK, Goligher EC, Slutsky AS. Searching for the optimal PEEP in patients without ARDS: High, low, or in between?. JAMA, 2020, 324(24): 2490-2492.
20.	钱颖, 谢永鹏, 沈叶菊, 等. 以机械功为导向的急性呼吸窘迫综合征机械通气新理念. 中国呼吸与危重监护杂志, 2020, 19(4): 418-421.
21.	Chi Y, He HW, Long Y. Progress of mechanical power in the intensive care unit. Chin Med J (Engl), 2020, 133(18): 2197-2204.
22.	Guérin C, Papazian L, Reignier J, et al. Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials. Crit Care, 2016, 20(1): 384.
23.	Serpa Neto A, Deliberato RO, Johnson AEW, et al. Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts. Intensive Care Med, 2018, 44(11): 1914-1922.
24.	Parhar KKS, Zjadewicz K, Soo A, et al. Epidemiology, mechanical power, and 3-year outcomes in acute respiratory distress syndrome patients using standardized screening. An observational cohort study. Ann Am Thorac Soc, 2019, 16(10): 1263-1272.
25.	谢永鹏, 钱颖, 刘克喜, 等. ARDS患者机械功与肺部超声评分的相关性以及二者对预后的评估价值. 中华危重病急救医学, 2019, 31(6): 704-708.
26.	Zhang ZH, Zheng B, Liu N, et al. Mechanical power normalized to predicted body weight as a predictor of mortality in patients with acute respiratory distress syndrome. Intensive Care Med, 2019, 45(6): 856-864.
27.	Coppola S, Caccioppola A, Froio S, et al. Effect of mechanical power on intensive care mortality in ARDS patients. Crit Care, 2020, 24(1): 246.
28.	Zhu YH, Peng WY, Zhen S, et al. Mechanical power normalized to predicted body weight is associated with mortality in critically ill patients: a cohort study. BMC Anesthesiol, 2021, 21(1): 278.
29.	Xie YP, Cao LJ, Qian Y, et al. Effect of deep sedation on mechanical power in moderate to severe acute respiratory distress syndrome: a prospective self-control study. Biomed Res Int, 2020, 2020: 2729354.
30.	Gattinoni L, Tonetti T, Quintel M. Regional physiology of ARDS. Crit Care, 2017, 21(Suppl 3): 312.
31.	Chiumello D, Froio S, Mistraletti G, et al. Gas exchange, specific lung elastance and mechanical power in the early and persistent ARDS. J Crit Care, 2020, 55: 42-47.
32.	Maiolo G, Collino F, Vasques F, et al. Reclassifying acute respiratory distress syndrome. Am J Respir Crit Care Med, 2018, 197(12): 1586-1595.
33.	Schmidt M, Pham T, Arcadipane A, et al. Mechanical ventilation management during extracorporeal membrane oxygenation for acute respiratory distress syndrome. An international multicenter prospective cohort. Am J Respir Crit Care Med, 2019, 200(8): 1002-1012.
34.	Belliato M, Epis F, Cremascoli L, et al. Mechanical power during veno-venous extracorporeal membrane oxygenation initiation: a pilot-study. Membranes (Basel), 2021, 11(1): 30.
35.	Chiu LC, Lin SW, Chuang LP, et al. Mechanical power during extracorporeal membrane oxygenation and hospital mortality in patients with acute respiratory distress syndrome. Crit Care, 2021, 25(1): 13.
36.	Ghiani A, Paderewska J, Walcher S, et al. Mechanical power normalized to lung-thorax compliance predicts prolonged ventilation weaning failure: a prospective study. BMC Pulm Med, 2021, 21(1): 202.
37.	Samary CS, Silva PL, Gama de Abreu M, et al. Ventilator-induced lung injury: power to the mechanical power. Anesthesiology, 2016, 125(5): 1070-1071.
38.	Fuller BM, Page D, Stephens RJ, et al. Pulmonary mechanics and mortality in mechanically ventilated patients without acute respiratory distress syndrome: a cohort study. Shock, 2018, 49(3): 311-316.
39.	Chiumello D, Formenti P, Bolgiaghi L, et al. Body position alters mechanical power and respiratory mechanics during thoracic surgery. Anesth Analg, 2020, 130(2): 391-401.
40.	Ball L, Volta CA, Saglietti F, et al. Associations between expiratory flow limitation and postoperative pulmonary complications in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth, 2022, 36(3): 815-824.
41.	Karalapillai D, Weinberg L, Neto AS, et al. Intra-operative ventilator mechanical power as a predictor of postoperative pulmonary complications in surgical patients: a secondary analysis of a randomised clinical trial. Eur J Anaesthesiol, 2022, 39(1): 67-74.
42.	Zhao ZQ, Frerichs I, He HW, et al. The calculation of mechanical power is not suitable for intra-patient monitoring under pressure-controlled ventilation. Intensive Care Med, 2019, 45(5): 749-750.
43.	Becher T, van der Staay M. Calculation of mechanical power for pressure-controlled ventilation: author's reply. Intensive Care Med, 2019, 45(10): 1498-1499.
44.	van der Meijden S, Somhorst P, Schoe A. Calculation of the mechanical power for pressure-controlled ventilation: a response. Intensive Care Med, 2020, 46(3): 568-569.
45.	Serpa Neto A, Deliberato RO, Johnson AE, et al. Normalization of mechanical power to anthropometric indices: impact on its association with mortality in critically ill patients. Intensive Care Med, 2019, 45(12): 1835-1837.
46.	Silva PL, Pelosi P, Rocco PRM. Understanding the mysteries of mechanical power. Anesthesiology, 2020, 132(5): 949-950.
47.	Vasques F, Duscio E, Pasticci I, et al. Is the mechanical power the final word on ventilator-induced lung injury? - we are not sure. Ann Transl Med, 2018, 6(19): 395.
48.	Tonna JE, Peltan I, Brown SM, et al. Mechanical power and driving pressure as predictors of mortality among patients with ARDS. Intensive Care Med, 2020, 46(10): 1941-1943.

1. Vasques F, Duscio E, Cipulli F, et al. Determinants and prevention of ventilator-induced lung injury. Crit Care Clin, 2018, 34(3): 343-356.
2. Gattinoni L, Quintel M. How ARDS should be treated. Crit Care, 2016, 20: 86.
3. Agostini P, Cieslik H, Rathinam S, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors?. Thorax, 2010, 65(9): 815-818.
4. O'Gara B, Talmor D. Perioperative lung protective ventilation. BMJ, 2018, 362: k3030.
5. Tonetti T, Cressoni M, Collino F, et al. Volutrauma, atelectrauma, and mechanical power. Crit Care Med, 2017, 45(3): e327-e328.
6. Protti A, Cressoni M, Santini A, et al. Lung stress and strain during mechanical ventilation: any safe threshold?. Am J Respir Crit Care Med, 2011, 183(10): 1354-1362.
7. Gattinoni L, Tonetti T, Cressoni M, et al. Ventilator-related causes of lung injury: the mechanical power. Intensive Care Med, 2016, 42(10): 1567-1575.
8. Tonetti T, Vasques F, Rapetti F, et al. Driving pressure and mechanical power: new targets for VILI prevention. Ann Transl Med, 2017, 5(14): 286.
9. Cressoni M, Gotti M, Chiurazzi C, et al. Mechanical power and development of ventilator-induced lung injury. Anesthesiology, 2016, 124(5): 1100-1108.
10. 孙秀梅, 王玉妹, 杨燕琳, 等. 机械功率在呼吸机相关性肺损伤的研究现状. 中华危重病急救医学, 2019, 31(12): 1549-1551.
11. Maia LA, Samary CS, Oliveira MV, et al. Impact of different ventilation strategies on driving pressure, mechanical power, and biological markers during open abdominal surgery in rats. Anesth Analg, 2017, 125(4): 1364-1374.
12. Santos RS, Maia LA, Oliveira MV, et al. Biologic impact of mechanical power at high and low tidal volumes in experimental mild acute respiratory distress syndrome. Anesthesiology, 2018, 128(6): 1193-1206.
13. Marini JJ, Rocco PRM, Gattinoni L. Static and dynamic contributors to ventilator-induced lung injury in clinical practice. Pressure, energy, and power. Am J Respir Crit Care Med, 2020, 201(7): 767-774.
14. Marini JJ, Rocco PRM. Which component of mechanical power is most important in causing VILI?. Crit Care, 2020, 24(1): 39.
15. Acute Respiratory Distress Syndrome Network; Brower RG, Matthay MA, Morris A, et al. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med, 2000, 342(18): 1301-1308.
16. Serpa Neto A, Cardoso SO, Manetta JA, et al. Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis. JAMA, 2012, 308(16): 1651-1659.
17. Futier E, Constantin JM, Paugam-Burtz C, et al. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery. N Engl J Med, 2013, 369(5): 428-437.
18. Mini G, Ray BR, Anand RK, et al. Effect of driving pressure-guided positive end-expiratory pressure (PEEP) titration on postoperative lung atelectasis in adult patients undergoing elective major abdominal surgery: a randomized controlled trial. Surgery, 2021, 170(1): 277-283.
19. Sahetya SK, Goligher EC, Slutsky AS. Searching for the optimal PEEP in patients without ARDS: High, low, or in between?. JAMA, 2020, 324(24): 2490-2492.
20. 钱颖, 谢永鹏, 沈叶菊, 等. 以机械功为导向的急性呼吸窘迫综合征机械通气新理念. 中国呼吸与危重监护杂志, 2020, 19(4): 418-421.
21. Chi Y, He HW, Long Y. Progress of mechanical power in the intensive care unit. Chin Med J (Engl), 2020, 133(18): 2197-2204.
22. Guérin C, Papazian L, Reignier J, et al. Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials. Crit Care, 2016, 20(1): 384.
23. Serpa Neto A, Deliberato RO, Johnson AEW, et al. Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts. Intensive Care Med, 2018, 44(11): 1914-1922.
24. Parhar KKS, Zjadewicz K, Soo A, et al. Epidemiology, mechanical power, and 3-year outcomes in acute respiratory distress syndrome patients using standardized screening. An observational cohort study. Ann Am Thorac Soc, 2019, 16(10): 1263-1272.
25. 谢永鹏, 钱颖, 刘克喜, 等. ARDS患者机械功与肺部超声评分的相关性以及二者对预后的评估价值. 中华危重病急救医学, 2019, 31(6): 704-708.
26. Zhang ZH, Zheng B, Liu N, et al. Mechanical power normalized to predicted body weight as a predictor of mortality in patients with acute respiratory distress syndrome. Intensive Care Med, 2019, 45(6): 856-864.
27. Coppola S, Caccioppola A, Froio S, et al. Effect of mechanical power on intensive care mortality in ARDS patients. Crit Care, 2020, 24(1): 246.
28. Zhu YH, Peng WY, Zhen S, et al. Mechanical power normalized to predicted body weight is associated with mortality in critically ill patients: a cohort study. BMC Anesthesiol, 2021, 21(1): 278.
29. Xie YP, Cao LJ, Qian Y, et al. Effect of deep sedation on mechanical power in moderate to severe acute respiratory distress syndrome: a prospective self-control study. Biomed Res Int, 2020, 2020: 2729354.
30. Gattinoni L, Tonetti T, Quintel M. Regional physiology of ARDS. Crit Care, 2017, 21(Suppl 3): 312.
31. Chiumello D, Froio S, Mistraletti G, et al. Gas exchange, specific lung elastance and mechanical power in the early and persistent ARDS. J Crit Care, 2020, 55: 42-47.
32. Maiolo G, Collino F, Vasques F, et al. Reclassifying acute respiratory distress syndrome. Am J Respir Crit Care Med, 2018, 197(12): 1586-1595.
33. Schmidt M, Pham T, Arcadipane A, et al. Mechanical ventilation management during extracorporeal membrane oxygenation for acute respiratory distress syndrome. An international multicenter prospective cohort. Am J Respir Crit Care Med, 2019, 200(8): 1002-1012.
34. Belliato M, Epis F, Cremascoli L, et al. Mechanical power during veno-venous extracorporeal membrane oxygenation initiation: a pilot-study. Membranes (Basel), 2021, 11(1): 30.
35. Chiu LC, Lin SW, Chuang LP, et al. Mechanical power during extracorporeal membrane oxygenation and hospital mortality in patients with acute respiratory distress syndrome. Crit Care, 2021, 25(1): 13.
36. Ghiani A, Paderewska J, Walcher S, et al. Mechanical power normalized to lung-thorax compliance predicts prolonged ventilation weaning failure: a prospective study. BMC Pulm Med, 2021, 21(1): 202.
37. Samary CS, Silva PL, Gama de Abreu M, et al. Ventilator-induced lung injury: power to the mechanical power. Anesthesiology, 2016, 125(5): 1070-1071.
38. Fuller BM, Page D, Stephens RJ, et al. Pulmonary mechanics and mortality in mechanically ventilated patients without acute respiratory distress syndrome: a cohort study. Shock, 2018, 49(3): 311-316.
39. Chiumello D, Formenti P, Bolgiaghi L, et al. Body position alters mechanical power and respiratory mechanics during thoracic surgery. Anesth Analg, 2020, 130(2): 391-401.
40. Ball L, Volta CA, Saglietti F, et al. Associations between expiratory flow limitation and postoperative pulmonary complications in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth, 2022, 36(3): 815-824.
41. Karalapillai D, Weinberg L, Neto AS, et al. Intra-operative ventilator mechanical power as a predictor of postoperative pulmonary complications in surgical patients: a secondary analysis of a randomised clinical trial. Eur J Anaesthesiol, 2022, 39(1): 67-74.
42. Zhao ZQ, Frerichs I, He HW, et al. The calculation of mechanical power is not suitable for intra-patient monitoring under pressure-controlled ventilation. Intensive Care Med, 2019, 45(5): 749-750.
43. Becher T, van der Staay M. Calculation of mechanical power for pressure-controlled ventilation: author's reply. Intensive Care Med, 2019, 45(10): 1498-1499.
44. van der Meijden S, Somhorst P, Schoe A. Calculation of the mechanical power for pressure-controlled ventilation: a response. Intensive Care Med, 2020, 46(3): 568-569.
45. Serpa Neto A, Deliberato RO, Johnson AE, et al. Normalization of mechanical power to anthropometric indices: impact on its association with mortality in critically ill patients. Intensive Care Med, 2019, 45(12): 1835-1837.
46. Silva PL, Pelosi P, Rocco PRM. Understanding the mysteries of mechanical power. Anesthesiology, 2020, 132(5): 949-950.
47. Vasques F, Duscio E, Pasticci I, et al. Is the mechanical power the final word on ventilator-induced lung injury? - we are not sure. Ann Transl Med, 2018, 6(19): 395.
48. Tonna JE, Peltan I, Brown SM, et al. Mechanical power and driving pressure as predictors of mortality among patients with ARDS. Intensive Care Med, 2020, 46(10): 1941-1943.

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机械功率在急性呼吸窘迫综合征患者和手术室机械通气患者中的应用

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