The role of mechanical power in lung ventilation for the prevention of ventilator-induced lung injury: a narrative review.

mechanical power per predicted body weight or per compliance) often outperform absolute mechanical power as predictors of outcome. Strategies to minimise mechanical power include individualised positive end-expiratory pressure titration, driving pressure limitation, and an optimised respiratory rate. Complementing traditional physiological analysis, this review highlights the emerging role of technological integration, specifically closed-loop ventilation and artificial intelligence-driven prediction models, as essential tools to bridge the gap between theoretical mechanical power concepts and bedside application.Mechanical power provides a unifying physiological framework that integrates volume, pressure, flow and frequency into a single descriptive measure of ventilatory load. While higher mechanical power is consistently associated with worse outcomes, current evidence does not support titrating ventilation to pre-defined numerical power thresholds, and prospective randomised trials are required to determine whether mechanical power-informed strategies improve patient-centred outcomes. Mechanical power should therefore be regarded as a contextual physiological descriptor rather than a standalone therapeutic target.