Comparison of Airway-Based and Transpulmonary Mechanical Power Across Ventilation Conditions in Moderate-to-Severe ARDS

Background

Mechanical ventilation is essential for managing acute respiratory distress syndrome (ARDS) but may contribute to ventilator-induced lung injury (VILI). Mechanical power (MP), an integrative measure combining tidal volume, respiratory rate, and airway pressures, has emerged as a predictor of VILI. However, conventional MP calculations based on airway driving pressure (ΔP) reflect the mechanical load applied to the entire respiratory system, including both lung parenchyma and chest wall. Estimation of transpulmonary pressure using esophageal pressure allows calculation of transpulmonary mechanical power (TPMP), which may more accurately represent lung stress.