Evidence map›Paper›PMID 42153811›Full record

SynthesisCritical care medicine2026

The Association Between Mechanical Power and Mortality in Critically Ill Patients Receiving Invasive Mechanical Ventilation: A Systematic Review and Meta-Analysis.

Ryota Sato, Shunsuke Kondo, Abulhassan Ali, Faris Abu Za'nouneh, Daisuke Hasegawa, Ehab G Daoud

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Critical care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ryota SatoDivision of Critical Care Medicine, Department of Medicine, The Queen's Medical Center, Honolulu, HI.ORCID 0000-0001-8806-2852
Shunsuke KondoDepartment of Medicine, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI.
Abulhassan AliDepartment of Medicine, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI.
Faris Abu Za'nounehDepartment of Medicine, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI.
Daisuke HasegawaDivision of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Ehab G DaoudDepartment of Medicine, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI.

Funding

NRSA Training CoreTL1TR001880 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI MEAGHER, EMMA ANNE · 2016 to 2025
$10.0M
NCATS NIH HHS TL1 TR001880
6 · The paper itself

Abstract

objectivesTo investigate the association between mechanical power and mortality in adult critically ill patients receiving invasive mechanical ventilation. DATA SOURCES: We conducted a systematic search of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials on August 12, 2025. STUDY SELECTION: We included studies comparing mechanical power between survivors and nonsurvivors or reporting adjusted mortality estimates in adult critically ill patients receiving invasive mechanical ventilation. DATA EXTRACTION: Two reviewers independently extracted study characteristics, ventilator variables, and mortality outcomes. DATA SYNTHESIS: Pooled mean differences (MDs) were calculated using inverse-variance random-effects models. Secondary analyses evaluated mechanical power normalized to predicted body weight and respiratory system compliance. Adjusted odds ratios (AORs) and adjusted hazard ratios (AHRs) for mortality per 1 J/min increase in mechanical power were synthesized separately using generic inverse-variance random-effects models. A total of 34 studies met inclusion criteria and were included in the meta-analyses. Mechanical power was higher in nonsurvivors than survivors (MD, 1.91 J/min; 95% CI, 1.30-2.51 J/min). Mechanical power normalized to predicted body weight (MD, 0.06 J/min/kg; 95% CI, 0.04-0.08 J/min/kg) and normalized to respiratory system compliance (MD, 0.28 J/min/mL/cm H 2 O; 95% CI, 0.10-0.45 J/min/mL/cm H 2 O) were also higher among nonsurvivors. Mechanical power was independently associated with mortality, with pooled AOR (1.04 per 1 J/min increase; 95% CI, 1.03-1.06 per 1 J/min increase) and pooled AHR (1.03; 95% CI, 1.00-1.07). A mechanical power threshold older than 17 J/min was associated with greater mortality (odds ratio, 1.60; 95% CI, 1.34-1.91).

conclusionsHigher mechanical power was consistently associated with increased mortality in invasively ventilated adults. Mechanical power may serve as a clinically relevant marker of ergotrauma; however, whether interventions that reduce mechanical power improve outcomes requires prospective investigation.

Indexed as

Critical IllnessRespiration, ArtificialHumansacute respiratory distress syndromeacute respiratory failuremechanical powermechanical ventilationventilator-induced lung injury

Identifiers

PMID42153811
PMCPMC13590212

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.