Model-Based Elastic–Resistive Partitioning of Inspiratory Mechanical Power During Conventional and Energy-Targeted Ventilation in a Hybrid Respiratory Simulator

Abstract Purpose Mechanical power provides a global description of the energetic load imposed by mechanical ventilation, but similar total values may reflect different elastic and resistive components. This study applied a model-based framework to characterize elastic and resistive inspiratory mechanical power during conventional and investigational energy-targeted ventilation in a hybrid respiratory simulator. Methods An experimental bench study was performed using a hybrid respiratory simulator coupled with a prototype ventilator. Four respiratory system conditions were simulated: normal mechanics and mild, moderate, and severe ARDS-like elastic impairment. Compliance was reduced from 60 to 30 mL/cmH 2 O, while resistance was kept constant at 10 cmH 2 O/L/s. Volume-controlled, pressure-controlled, and mechanical power-controlled ventilation were evaluated at respiratory rates of 10, 15, and 20 breaths/min. Maximal and mean elastic and resistive inspiratory mechanical power were assessed. Results Ventilation mode significantly affected all analyzed power components. Mechanical power-controlled ventilation produced the lowest pooled maximal elastic power, with reductions of 16.2% versus volume-controlled ventilation and 24.3% versus pressure-controlled ventilation (both p < 0.001). This effect was most evident at lower respiratory rates and under more severe elastic impairment. For resistive power, pressure-controlled ventilation produced the highest values, volume-controlled ventilation the lowest, and mechanical power-controlled ventilation remained intermediate. Conclusion Component-level analysis revealed ventilation mode-dependent differences in inspiratory energy transfer that were not captured by total mechanical power alone.