ArticleCritical care (London, England)2020
Energy transmission in mechanically ventilated children: a translational study.
Article in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 18 citations in OpenAlex.
- Association of compliance-normalized airway and transpulmonary mechanical power with mortality in PARDS.European journal of pediatrics · 2026Observational
- Practice of ventilation in critically ill pediatric patients: protocol for an international, long-term, observational study, and results of the pilot feasibility study.Critical care science · 2025Observational
- What every paediatrician needs to know about mechanical ventilation.European journal of pediatrics · 2024Review
- Speed of lung inflation at birth influences the initiation of lung injury in preterm lambs.JCI insight · 2024Article
- Mechanical power and normalized mechanical power in pediatric acute respiratory distress syndrome.Frontiers in pediatrics · 2024Article
- The Impact of Mechanical Energy Assessment on Mechanical Ventilation: A Comprehensive Review and Practical Application.Medical science monitor : international medical journal of experimental and clinical research · 2023Review
- Is mechanical power an under-recognised entity within the preterm lung?Intensive care medicine experimental · 2023Article
- Mechanical power in pediatric acute respiratory distress syndrome: a PARDIE study.Critical care (London, England) · 2022Observational
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecurrent delivery of tidal mechanical energy (ME) inflicts ventilator-induced lung injury (VILI) when stress and strain exceed the limits of tissue tolerance. Mechanical power (MP) is the mathematical description of the ME delivered to the respiratory system over time. It is unknown how ME relates to underlying lung pathology and outcome in mechanically ventilated children. We therefore tested the hypothesis that ME per breath with tidal volume (Vt) normalized to bodyweight correlates with underlying lung pathology and to study the effect of resistance on the ME dissipated to the lung.
methodsWe analyzed routinely collected demographic, physiological, and laboratory data from deeply sedated and/or paralyzed children < 18 years with and without lung injury. Patients were stratified into respiratory system mechanic subgroups according to the Pediatric Mechanical Ventilation Consensus Conference (PEMVECC) definition. The association between MP, ME, lung pathology, and duration of mechanical ventilation as a primary outcome measure was analyzed adjusting for confounding variables and effect modifiers. The effect of endotracheal tube diameter (ETT) and airway resistance on energy dissipation to the lung was analyzed in a bench model with different lung compliance settings.
resultsData of 312 patients with a median age of 7.8 (1.7-44.2) months was analyzed. Age (p < 0.001), RR p < 0.001), and Vt < 0.001) were independently associated with MPrs. ME but not MP correlated significantly (p < 0.001) better with lung pathology. Competing risk regression analysis adjusting for PRISM III 24 h score and PEMVECC stratification showed that ME on day 1 or day 2 of MV but not MP was independently associated with the duration of mechanical ventilation. About 33% of all energy generated by the ventilator was transferred to the lung and highly dependent on lung compliance and airway resistance but not on endotracheal tube size (ETT) during pressure control (PC) ventilation.
conclusionsME better related to underlying lung pathology and patient outcome than MP. The delivery of generated energy to the lung was not dependent on ETT size during PC ventilation. Further studies are needed to identify injurious MErs thresholds in ventilated children.
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