弹性静态功率与急性呼吸窘迫综合征严重程度的相关性:机械功率日横断面试验的贝叶斯事后分析

Aurio Fajardo-Campoverdi, Alejandro González-Castro, Vicent Modesto I Alapont, Miguel Ibarra-Estrada, Carmen Chica-Meza, Alberto Medina, Patricia Escudero-Acha, Denise Battaglini, Patricia R M Rocco, Chiara Robba, Paolo Pelosi
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引用次数: 0

摘要

目的:不同幂方程与急性呼吸窘迫综合征(ARDS)严重程度的关系尚不清楚。本研究旨在评估一组伴有和不伴有ARDS的机械通气患者的各种功率方程:总机械功率、总弹性功率(包括弹性静态功率和弹性动态功率)和阻力功率。贝叶斯分析通过纳入先验分布来改进估计和量化不确定性。设计:对机械动力日研究的数据进行贝叶斯事后分析。环境:遍布4大洲15个国家的113个重症监护室。患者:在容量控制模式下接受有创机械通气的成人,有(轻度和中度/重度ARDS)和无ARDS。干预措施:没有。主要感兴趣的变量:ARDS,弹性静功率。结果:轻度ARDS患者弹性静功率为5.8 J/min (BF: 0.3),中重度ARDS患者弹性静功率为7.4 J/min (BF: 0.9)。贝叶斯回归和建模分析表明,弹性静力与轻度(后验均值:1.3;95%可信区间[间隔]:0.2-2.2)和中度/重度ARDS(后验平均值:2.8;95%的信誉。区间:1.7-3.8)比其他幂方程更强。结论:弹性静功率与ARDS严重程度的相关性最强。需要前瞻性研究来进一步验证这些发现。
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Elastic static power, its correlation with acute respiratory distress syndrome severity: A Bayesian post-hoc analysis of the Mechanical Power Day cross-sectional trial.

Objective: The relationship between different power equations and the severity of acute respiratory distress syndrome (ARDS) remains unclear. This study aimed to evaluate various power equations: total mechanical power, total elastic power (comprising elastic static and elastic dynamic power), and resistive power, in a cohort of mechanically ventilated patients with and without ARDS. Bayesian analysis was employed to refine estimates and quantify uncertainty by incorporating a priori distributions.

Design: A Bayesian post-hoc analysis was conducted on data from the Mechanical Power Day study.

Setting: 113 intensive care units across 15 countries and 4 continents.

Patients: Adults who received invasive mechanical ventilation in volume-controlled mode, with (mild and moderate/severe ARDS) and without ARDS.

Interventions: None.

Main variables of interest: ARDS, Elastic static power.

Results: Elastic static power was 5.8 J/min (BF: 0.3) in patients with mild ARDS and 7.4 J/min (BF: 0.9) in moderate/severe ARDS patients. Bayesian regression and modeling analysis revealed that elastic static power was independently correlated with mild (a posteriori Mean: 1.3; 95% Credible Interval [Cred. Interval]: 0.2-2.2) and moderate/severe ARDS (a posteriori Mean: 2.8; 95% Cred. Interval: 1.7-3.8) more strongly than other power equations.

Conclusions: Elastic static power was found to have the strongest correlation with ARDS severity among the power equations studied. Prospective studies are needed to further validate these findings.

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