Related Experiment Video
Updated: Jan 16, 2026
Author Spotlight: Unraveling the Impact of Mechanical Ventilation on Diaphragm Function and Patient Outcomes
Published on: November 3, 2023
Mechanical power in children undergoing mechanical ventilation: A systematic review
Adriana Koliski1, Valéria Cabral Neves1, Natália Fracaro Lombardi Asinelli1
1Pediatric Intensive Care Unit, Complexo Hospital de Clínicas da Universidade Federal do Paraná, Brazil.
Insights
Mechanical power (MP) in pediatric patients is linked to longer ventilation duration and higher mortality. Adjusting MP for body weight is crucial for assessing risk in critically ill children.
Area of Science:
- Pediatric Critical Care Medicine
- Respiratory Physiology
- Mechanical Ventilation
Background:
- Mechanical power (MP) quantifies energy delivered to lungs during mechanical ventilation.
- Understanding MP's role in pediatric respiratory failure is critical for improving outcomes.
- This review synthesizes current pediatric research on MP and its clinical associations.
Purpose of the Study:
- To systematically review pediatric studies on mechanical power.
- To examine the association between mechanical power and ventilation duration.
- To investigate the relationship between mechanical power and mortality in children.
Main Methods:
- Systematic literature search across major databases (PubMed, Embase, Scopus, etc.) following PRISMA guidelines.
- Inclusion of all articles on mechanical power, with subsequent selection for pediatric populations.
- Risk of bias assessment using the Newcastle-Ottawa scale.
Main Results:
- Nine studies involving 1769 children were included; no randomized controlled trials were found.
- Elevated mechanical power values were consistently associated with increased mortality and prolonged ventilation duration.
- MP adjusted for body weight, especially within 24 hours of ventilation, showed stronger correlations with adverse outcomes.
Conclusions:
- Mechanical power is a measurable parameter in pediatric patients on pressure-controlled ventilation.
- Adjusting mechanical power for body weight is recommended for accurate risk assessment.
- Further research is required to establish definitive risk thresholds for mechanical power in children.
Background:
Mechanical power (MP) estimates the energy delivered to the lungs during ventilation. This study reviews pediatric research on MP and its association with ventilation duration and mortality.
Methods:
According to the PRISMA guidelines, a systematic search was conducted in the databases Pubmed, Embase, Scopus, Web of Science, Lilacs, and Cochrane. A manual search was performed in the bibliography of the included studies and in the grey literature. All articles on mechanical power were included, and then studies focusing on the pediatric population were selected. The risk of bias was assessed using the Newcastle-Ottawa scale.
Results:
Nine articles were included. No randomized controlled trials were found. A total of 1769 children were included, of whom 1417 were diagnosed with acute respiratory distress syndrome (ARDS), while 148 had no evidence of lung injury. The median age ranged from 5.7 to 114 months, and 275 children died. MP values were found to be associated with increased mortality. Most studies utilized adaptations of the Gattinoni or Becher formulas. In children without lung pathology, average MP values were 3.93 ± 1.1 J/min. For children with ARDS, median MP values were 10 J/min in survivors and 15 J/min in non-survivors. Elevated MP values, particularly when assessed dynamically within the first 24 h of ventilation and adjusted for body weight, were consistently associated with increased mortality and, in some studies, prolonged ventilation duration.
Conclusion:
Mechanical power can be measured in children on pressure-controlled ventilation, preferably adjusted for body weight. Further research is needed to define risk thresholds.
Related Concept Videos
01:29Mechanical Ventilation I: Indication and Settings
01:23Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
01:14Ventilatory Modes
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement: