Role of Changes in Driving Pressure and Mechanical Power in Predicting Mortality in Patients with Acute Respiratory Distress Syndrome

Abstract

Driving pressure (ΔP) and mechanical power (MP) are associated with increased mortality in patients with acute respiratory distress syndrome (ARDS). We aimed to investigate which was better to predict mortality between changes in ΔP and MP. We reanalyzed data from a prospective observational cohort study of patients with ARDS in our hospital. Serial ΔP and MP values were calculated. The factors associated with survival were analyzed. Binary logistic regression showed that age (odds ratio (OR), 1.012; 95% confidence interval (CI), 1.003–1.022), Sequential Organ Failure assessment (SOFA) score (OR, 1.144; 95% CI, 1.086–1.206), trauma (OR, 0.172; 95% CI, 0.035–0.838), ΔP (OR, 1.077; 95% CI, 1.044–1.111), change in ΔP (OR, 1.087; 95% CI, 1.054–1.120), and change in MP (OR, 1.018; 95% CI, 1.006–1.029) were independently associated with 30-day mortality. Change in MP, change in ΔP, and SOFA scores were superior to ΔP in terms of the accuracy of predicting 30-day mortality. In conclusion, calculating change in ΔP is easy for respiratory therapists in clinical practice and may be used to predict mortality in patients with ARDS.

Keywords

• driving pressure
• mechanical power
• mortality
• acute respiratory distress syndrome