Ventilator-induced lung injury (VILI) carries significant attributable mortality in acute respiratory distress syndrome (ARDS). Even though all the ventilatory variables contribute to VILI, current guidelines focus almost exclusively on tidal volume (VT) and plateau pressure/driving pressure (ΔP).

In 2016, we formalised the concept of mechanical power (MP) with the aim to: quantify the contribution of respiratory rate (RR) and the positive end-expiratory pressure (PEEP) to the total power delivered by the ventilator; aggregate these variables into a single physical measure, whose value might relate to the risk of VILI.

In this manuscript, we aim to review the conceptual and analytical derivation of the MP, discuss the role of each component in the generation of VILI and the association between MP and outcome.

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