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The following is a summary of “Mechanical power is not associated with mortality in COVID-19 mechanically ventilated patients,” published in the February 2025 issue of Annals of Intensive Care by Barbeta et al. 

The contribution of different components of mechanical power (MP) to mortality was debated and had not been specifically studied in COVID-19. 

Researchers conducted a retrospective study to assess the total and relative impact of each MP component on mortality in patients with COVID-19-induced acute respiratory failure receiving invasive mechanical ventilation (MV). 

They performed a secondary analysis of the CIBERESUCICOVID project across 50 Spanish intensive care units. It included 799 mechanically ventilated COVID-19 patients from February 2020 to December 2021 and assessed the relationship between MP and its components [elastic static, elastic dynamic, total elastic, and resistive power(R)] with 90-day mortality, adjusting for confounders. 

The results showed that at the start of MV, the partial pressure of oxygen to the fraction of inspired oxygen (PaO₂ /FiO₂) ratio was 106 (78; 150), the ventilatory ratio was 1.69 (1.40; 2.05), and respiratory system compliance measured 35.7 (29.2; 44.5) ml per cm of water (ml/cmH₂O). The MP was 24.3 (18.9; 29.6) J/min and remained stable after 3 days. Multivariable regression analysis found no link between MP or its components and 90-day mortality at initiation. However, after 3 days, total elastic and elastic static power were associated with higher 90-day mortality, along with positive end-expiratory pressure (PEEP). 

Investigators concluded that initial MP metrics did not predict COVID-19 mortality, but after 3 days, specific elastic power measures correlated with decreased survival, a risk also reflected by PEEP and plateau pressure. 

Source: https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-025-01430-6