Abstract Rationale Mechanical power represents the energy delivered to the lungs by positive pressure ventilation. Higher mechanical power may increase ventilator-induced lung injury (VILI), ultimately leading to a higher risk of mortality in critically ill patients. Age-related alterations in lung mechanics, including reduced compliance and increased airway resistance, may heighten vulnerability to VILI at specific mechanical power exposures. Since structural and molecular changes in lung tissue are also contributing factors in VILI. this study aims to investigate the relationship among age, mechanical power, and mortality in mechanically ventilated ICU patients. Method This retrospective study was conducted in the intensive care units of Taichung Veterans General Hospital (TCVGH) between 2015 and 2020. Adult patients who underwent continuous control or assisted mechanical ventilation for at least four consecutive days from ICU admission were included for analysis. Ventilator parameters were recorded three times daily (01:00, 09:00, and 17:00), and the median calculated mechanical power value for each day was used as the daily representative measure. Patients were categorized into three age groups (65 years, 65-80 years, and ≥81 years) to compare clinical characteristics and outcomes across different ages. Result A total of 4,441 critically ill patients were included, with 63.2% being male and a mean age of 64.4 ± 15.9 years. Overall hospital mortality was 32.7% (1,452 patients), while 67.3% survived. Mortality rates rose with age, particularly in patients aged ≥81 years (32.0% in 65 years; 31.9% in 65-80 years; 35.3% in ≥ 81 years; p 0.001). Higher mechanical power was also associated with increased hospital mortality (25.1% for MP 16; 30.6% for MP 16-20; 41.3% for MP 20; p 0.001). Patients who were both older and exposed to higher mechanical power demonstrated the highest mortality risk. Conclusion Increased mechanical power and advanced age may contribute to higher mortality in critically ill patients synergistically. These findings suggest that elderly patients are more vulnerable to ventilator-induced lung injury, subsequently leading to worse clinical outcomes. This abstract is funded by: None
Chan et al. (Fri,) studied this question.