Reproducibility of Mechanical Power Equations in Ventilated Critically Ill Children

Ventilation Practitioner Agnes Maas schreef dit artikel

Objectives: 

We aimed to assess the reproducibility of mechanical power (MP) equations in comparison with the geometric method in critically ill children during respiratory support with invasive pressure-controlled ventilation (PCV).

Design: 

Prospective, exploratory research study.

Setting: 

Single-center, PICU in The Netherlands.

Patients: 

Children (< 18 yr old) admitted to the PICU receiving PCV.

Interventions: 

None.

Measurements and Main Results: 

MP was calculated in a cohort of 37 children, with a median (interquartile range [IQR]) age of 12 months (IQR, 2–60 mo). Three, previously proposed MP equations (simplified, comprehensive, and linear MP) were compared with the geometric mean (“gold standard”), measuring the area-under-the-pressure-volume-loop, and assessed using agreement (Bland-Altman) analysis and reliability (intraclass correlation coefficient [ICC]) analysis of parameters. The mean difference (95% CI) was as follows: simplified MP –0.02 J/min (95% CI, –1.02 to 0.99 J/min), comprehensive MP 0.03 J/min (95% CI, –0.94 to 1.00 J/min), and linear MP 0.16 J/min (95% CI, –0.76 to 1.08 J/min). The ICCs for all comparisons were excellent (i.e., > 0.99; p < 0.001).

Conclusions: 

In critically ill children undergoing invasive PCV, all three MP equations acceptably reproduce the geometric method for calculating MP in J/min.

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