Determinants of transpulmonary (TP) mechanical power. Transpulmonary mechanical power was computed from dynamic transpulmonary pressure–volume curves (collected throughout the study) and is presented in relation to three possible determinants of ventilator-induced lung injury. Changes from baseline in intratidal opening and closing, strain, and extent of lung inhomogeneities are divided into quartiles, and the changes in delivered dynamic transpulmonary energy are presented as mean ± standard error. Regression lines were not computed on means but on individual data points (see Supplemental Digital Content 1, https://links.lww.com/ALN/B259). (A) Δ Delivered dynamic transpulmonary energy (J) = 0.09 + 0.03 × Δ intratidal opening and closing (%), r² = 0.23, P < 0.0001. (B) Δ Delivered dynamic transpulmonary energy (J) = 0.23 + 0.24 × Δ strain, r² = 0.14, P < 0.0001. (C) Δ Delivered dynamic transpulmonary energy (J) = 0.08 + 0.04 × Δ lung inhomogeneity (%), r² = 0.37, P < 0.0001.