Mechanical power in children undergoing mechanical ventilation: A systematic review

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.