![]() Experimentally we found in 30 kg pigs, a safe threshold was between an upper threshold of 12 J/min and a lower threshold of 4–7 J/min. A “normal” MP provides acceptable PO 2 and PCO 2 and is included within safe boundaries. Important questions are about the definition of a safe MP is, and the appropriate upper and lower safety thresholds. All these proposed variables have, however, predictive values comparable with MP, which is unsurprising given that they all share the same component. Its prognostic value has been compared with single variables (e.g., ΔP), and more recently with a combination of driving pressure and frequency: 4 × ΔP + RR which reflects the relative effect on the odds of death. Several studies including ARDS and non-ARDS patients have now demonstrated the association between MP and mortality. FRC: functional residual capacity, MP: mechanical power, PEEP: positive end-expiratory pressure, PEEP vol: Volume related to PEEP, VT: tidal volume, RR: respiratory rate The total MP could therefore be normalised based on anthropometric values or functional values in normal subjects or ventilated patients with normal lungs. Personalization: In the future we envisage that the protective value of MP may be calculated for each individual patient (personalised) in relationship to anatomical or physiological characteristics. Several power formulas have been proposed for controlled and spontaneous ventilation. Epidemiological validation: To date the MP has been studied using epidemiological data, assessing the association between MP and mortality to identify a safe MP threshold. A MP value between 12 and 4–7 J/min was associated with the lowest injury assessed using anatomical and physiological variables. ![]() ![]() Iso-MP achieved adjusting TV or RR or PEEP is responsible for the iso-damage to the lungs. The key role of PEEP: the energy required to move the lung from its resting position (FRC) to the end-inspiratory volume, is the sum of the static component (due to PEEP) and the elastic component (due to VT). Physiological foundations are based on experimental studies: A. ![]()
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