ArticleCritical care science2025
Stepwise positive end-expiratory pressure titration modulates respiratory mechanics and mechanical power in mechanically ventilated adults.
Article in Critical care science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Bedside Assessment of PEEP-Induced Volume and Mechanical Power in Mechanically Ventilated Adults Without ARDS: A Post Hoc Analysis.Medical sciences (Basel, Switzerland) · 2026Article
- Physiology-guided personalized mechanical ventilation to prevent ventilator-induced lung injury.Frontiers in medicine · 2026Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the impact of an ascending positive end-expiratory pressure titration strategy on respiratory mechanics and mechanical power in patients without lung injury.
methodsAn incremental positive end-expiratory pressure titration was performed in 4cmH2O steps, starting from zero end-expiratory pressure and progressing to 16cmH2O. Differences (Δ) in respiratory system static compliance, plateau pressure, driving pressure, and mechanical power were assessed during lung-protective ventilation. Mechanical power formulas proposed by Gattinoni et al. and Costa et al. were used. Analyses were also performed on the static elastic components, dynamic elastic components, total elastic power, and resistive components.
resultsIncreasing positive end-expiratory pressure levels were associated with a progressive rise in mechanical power, plateau pressure, total and static elastic power, and a decline in compliance. Mechanical power showed strong positive correlations with: ΔPplat (p < 0.001); Δelastic dynamic power (p < 0.001); Δdriving pressure (p < 0.001); and Δtotal elastic power (p < 0.001). Δmechanical power correlated strongly with Δresistive power (p < 0.001), but not with other mechanical power components or mechanics.
conclusionProgressive positive end-expiratory pressure increase in patients without lung disease significantly raises total mechanical power and its elastic components, particularly static elastic power. These changes may occur silently and without significant alterations in driving pressure or compliance.
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