Optimizing mechanical power for lung protective ventilation - a simulation study

A optimization framework for lung-protective ventilation that minimizes mechanical power while tracking a target minute ventilation (MV) is presented. The objective uses driving pressure, inspiratory and expiratory time as input, and is constrained by clinically relevant bounds. We tested the method in silico on a virtual cohort with (Formula presented) and (Formula presented), assuming for all virtual patients to be a female with 58 kg ideal body weight and a target MV=6lmin. Restrictive profiles favored high rates and low tidal volumes, whereas obstructive profiles chose the opposite. Elastic-dynamic MP contributed up to 76 % for the smallest time constants of 0.02 s, while resistive MP reached up to 68 % in high time constant scenarios above 2 s. These results agree with previous work and support using MP as a unifying metric for developing assistive, lung-protective ventilation strategies.