- High mechanical power and driving pressure may be associated with pulmonary complications in patients undergoing general anesthesia with mechanical ventilation.
- In this retrospective registry study, medical records for patients undergoing noncardiac procedures under general anesthesia were evaluated for exposure to low versus high (>7 J/min) mechanical power (primary exposure) and low versus high (>15 cm H20) driving pressure (secondary exposure).
- The primary endpoint was respiratory complication defined as reintubation or unplanned noninvasive ventilation within seven days of the procedure.
- Patient records between 2008 and 2020 were analyzed, resulting in inclusion of 97,555 patients, of which 4,030 (4.1%) developed respiratory complication.
- Patients exposed to high intraoperative mechanical power had higher odds of respiratory complication (adjusted odds ratio [aOR] 1.37 [95% CI, 1.25–1.50]; p < 0.001) as did patients exposed to high driving pressure (aOR 1.45 [95% CI, 1.31–1.60]; p < 0.001)
- Additional analysis of matching patients by baseline respiratory system compliance yielded similar results with both high mechanical power and driving pressures associated with increased odds of respiratory complication.
- It was also observed that significant variability in applied ventilatory parameters existed between anesthesia providers.
- In conclusion, exposures to high mechanical power and driving pressure are associated with postoperative respiratory complication defined as unplanned intubation or noninvasive positive pressure ventilation within seven days of the procedure.
- Clinicians should consider accounting for mechanical power and driving pressure when determining ventilation parameters for individual patients.
Summary of "High Mechanical Power and Driving Pressures are Associated With Postoperative Respiratory Failure Independent From Patients’ Respiratory System Mechanics"
Summary published August 1, 2024