Clinical Study On Mechanical Power Guidance To Reduce Ventilatorinduced Lung Injury In Patients With ARDS

Objective: The purpose of this study is to explore the relationship between mechanical power and the duration of mechanical ventilation of patients with moderate to severe ARDS,and to explore the significance of its application in guiding clinical treatment and reducing ventilator-related lung injury,and validate in clinical use.Methods: A total of 126 patients with ARDS were enrolled in the study and retrospectively analyzed.Clinicopathological data including age,gender,etiology of ARDS,APACHE II score,blood lactic acid level(LAC),C-reactive protein(CRP),procalcitonin(PCT),oxygenation index,smoking history,hypertension history,diabetes history,lung compliance,duration of mechanical ventilation and simplified mechanical power were collected,Patients were divided into two groups according to the duration of mechanical ventilation.For each factor,univariate analysis,univariate and multivariate logistic regression analysis were used to evaluate the correlation between mechanical power and other factors and weaning failure of ARDS patients,and the OR and 95% confidence interval were obtained.The ROC curve was established to evaluate the predictive power of mechanical power,and the critical value was calculated.A new mechanical ventilation scheme was designed with mechanical energy and verified in clinicResults: The logistics regression analysis of single factor and multi factor showed that the simplified mechanical power was significantly related to Failed ventilator weaning(or =0.789);95% CI: 0.671-0.927),and APACHE II score,blood lactic acid concentration and C-reactive protein were independent risk factors for weaning failure(P < 0.05).The area under ROC curve with mechanical energy index was larger than that without mechanical energy index(0.898 vs 0.755).The critical value of mechanical energy was 21.16j/min(sensitivity 0.478,specificity 0.932).The duration of mechanical ventilation was shortened after mechanical energy guided ventilation.Conclusion: The mechanical power calculated by the simplified formula is significantly correlated with the duration of mechanical ventilation in patients with moderate to severe ARDS.The duration of mechanical ventilation was shortened after mechanical energy guided ventilation.