Rationale: Airway occlusion pressure at 100 ms (P0.1) reflects central respiratory drive. Objectives: We aimed to assess factors associated with P0.1 and whether an abnormally low or high P0.1 value is associated with higher mortality and longer duration of mechanical ventilation (MV). Methods: We performed a secondary analysis of a prospective cohort study conducted in 10 ICUs in France to evaluate dyspnea in communicative MV patients. In patients intubated for more than 24 hours, P0.1 was measured with dyspnea as soon as patients could communicate and the next day. Measurements and Main Results: Among 260 patients assessed after a median time of ventilation of 4 days, P0.1 was 1.9 (1-3.5) cm H2O at enrollment, 24% had P0.1 values >3.5 cm H2O, 37% had P0.1 values between 1.5 and 3.5 cm H2O, and 39% had P0.1 values <1.5 cm H2O. In multivariable linear regression, independent factors associated with P0.1 were the presence of dyspnea (P = 0.037), respiratory rate (P < 0.001), and PaO2 (P = 0.008). Ninety-day mortality was 33% in patients with P0.1 > 3.5 cm H2O versus 19% in those with P0.1 between 1.5 and 3.5 cm H2O and 17% in those with P0.1 < 1.5 cm H2O (P = 0.046). After adjustment for the main risk factors, P0.1 was associated with 90-day mortality (hazard ratio per 1 cm H2O, 1.19 [95% confidence interval, 1.04-1.37]; P = 0.011). P0.1 was also independently associated with a longer duration of MV (hazard ratio per 1 cm H2O, 1.10 [95% confidence interval, 1.02-1.19]; P = 0.016). Conclusions: In patients receiving invasive MV, abnormally high P0.1 values may suggest dyspnea and are associated with higher mortality and prolonged duration of MV.

中文翻译：

---

高气道闭塞压与危重机械通气患者的呼吸困难和死亡率增加有关。


基本原理：100 毫秒时的气道闭塞压力 (P0.1) 反映了中枢呼吸驱动。目的：我们旨在评估与 P0.1 相关的因素，以及异常低或高的 P0.1 值是否与较高的死亡率和较长的机械通气 (MV) 持续时间相关。方法：我们对在法国 10 个 ICU 进行的一项前瞻性队列研究进行了二次分析，以评估交流性 MV 患者的呼吸困难。对于插管超过24小时的患者，在患者能够沟通时和第二天测量呼吸困难的P0.1。测量和主要结果：在 4 天平均通气时间后评估的 260 名患者中，入组时 P0.1 为 1.9 (1-3.5) cm H2O，24% 的 P0.1 值为 >3.5 cm H2O，37% P0.1 值在 1.5 至 3.5 cm H2O 之间，39% 的 P0.1 值在 <1.5 cm H2O 之间。在多变量线性回归中，与 P0.1 相关的独立因素是呼吸困难 (P = 0.037)、呼吸频率 (P < 0.001) 和 PaO2 (P = 0.008)。 P0.1 > 3.5 cm H2O 患者的 90 天死亡率为 33%，P0.1 1.5 至 3.5 cm H2O 患者的 90 天死亡率为 19%，P0.1 < 1.5 cm H2O 患者的 90 天死亡率为 17%（P = 0.046）。调整主要危险因素后，P0.1 与 90 天死亡率相关（每 1 cm H2O 的风险比，1.19 [95% 置信区间，1.04-1.37]；P = 0.011）。 P0.1 也与较长的 MV 持续时间独立相关（每 1 cm H2O 的风险比，1.10 [95% 置信区间，1.02-1.19]；P = 0.016）。结论：在接受侵入性 MV 的患者中，异常高的 P0.1 值可能提示呼吸困难，并与较高的死亡率和 MV 持续时间延长相关。