Can mechanical power be used as a safety precaution in pediatric patients? Pediyatrik hastalarda guvenlik onlemi olarak mekanik guc kullanilabilir mi?


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Yuksek A., MİNİKSAR Ö. H., YARDIMCI C., Cikrikci A. P.

Anestezi Dergisi, vol.30, no.4, pp.232-239, 2022 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 30 Issue: 4
  • Publication Date: 2022
  • Doi Number: 10.54875/jarss.2022.83713
  • Journal Name: Anestezi Dergisi
  • Journal Indexes: Scopus, Academic Search Premier, Central & Eastern European Academic Source (CEEAS), EMBASE, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.232-239
  • Keywords: Mechanical power, Mechanical ventilation, Pediatric anesthesia
  • Yozgat Bozok University Affiliated: Yes

Abstract

© 2022 Anestezi Dergisi. All rights reserved.Objective: Mechanical power (MP) is the amount of energy transferred to the respiratory system of patients during each breath period. After overcoming the resistances required for respiration, the remaining energy may end up by damaging the lung parenchyma. The MP limit that should not be exceeded in pediatric patients is not yet clear. The aim of this observational descriptive study is to compare the perioperative MP measurements in healthy pediatric cases with the values given in the literature. Methods: Perioperative MP was calculated according to the simplified MP formula in pediatric patients without known lung disease and compared with the literature. Results: The mean age of 34 patients was 68.8831.4 months and the mean weight was 21.827.5 kg. The mean MP was 3.931.1 J min-1, and the indexed MP was 0.190.08 J min-1 kg-1. Both MP (p=0.008) and indexed MP (p0.001) were significantly higher in patients with high tidal volume. In addition, we found a negative correlation between indexed MP and weight (r:-668 and p0.001). Both MP and indexed MP had sufficient predictive power to predict tidal volume 10 and predictive value was significant [Auc: 0.764, 95%CI: 0.55-0.97, p: 0.026]. The value of MP3.76 was an indicator for tidal volume 10 with 87 sensitivity and 50 specificity. Predictive value of indexed MP for tidal volume 10 mL kg-1 was 0.25 J kg-1 [AUC 0.856, 95%CI: 0.70-1.0, p=0.003], and indexed MP was a stronger indicator than MP. Conclusion: This study revealed that MP threshold values calculated for adults or patients with ARDS lung are not sensitive for pediatric patients, and a new threshold value should be determined for these patients.