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mechanical-power

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Study on mechanical power in MIMIC-III and eICU-CRD

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# mechanical-power [![DOI](https://zenodo.org/badge/91024233.svg)](https://zenodo.org/badge/latestdoi/91024233)

Study on mechanical power in MIMIC-III and eICU-CRD.

If using this code, please cite the above DOI as follows:

Johnson, Alistair E W, Rodrigo O. Deliberato, Art S. Neto. alistairewj/mechanical-power: Mechanical Power v1.0.0. Zenodo. DOI: 10.5281/zenodo.3263855.

We would also be grateful if you would cite the relevant article:

Neto, Ary S.*, Rodrigo O. Deliberato*, Alistair E. W. Johnson*, Lieuwe D. Bos*, Pedro Amorim, Silvio Moreto Pereira, Denise Carnieli Cazati et al. "Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts." Intensive care medicine 44, no. 11 (2018): 1914-1922.

\* Equal contribution.

Link to article: https://doi.org/10.1007/s00134-018-5375-6

# Abstract

## Purpose
Mechanical power (MP) may unify variables known to be related to development of ventilator-induced lung injury. The aim of this study is to examine the association between MP and mortality in critically ill patients receiving invasive ventilation for at least 48 h.

## Methods
This is an analysis of data stored in the databases of the MIMIC–III and eICU. Critically ill patients receiving invasive ventilation for at least 48 h were included. The exposure of interest was MP. The primary outcome was in-hospital mortality.

## Results
Data from 8207 patients were analyzed. Median MP during the second 24 h was 21.4 (16.2–28.1) J/min in MIMIC-III and 16.0 (11.7–22.1) J/min in eICU. MP was independently associated with in-hospital mortality [odds ratio per 5 J/min increase (OR) 1.06 (95% confidence interval (CI) 1.01–1.11); p = 0.021 in MIMIC-III, and 1.10 (1.02–1.18); p = 0.010 in eICU]. MP was also associated with ICU mortality, 30-day mortality, and with ventilator-free days, ICU and hospital length of stay. Even at low tidal volume, high MP was associated with in-hospital mortality [OR 1.70 (1.32–2.18); p < 0.001] and other secondary outcomes. Finally, there is a consistent increase in the risk of death with MP higher than 17.0 J/min.

## Conclusion
High MP of ventilation is independently associated with higher in-hospital mortality and several other outcomes in ICU patients receiving invasive ventilation for at least 48 h.

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