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Anesthesia workstation performance in pediatric ventilation - Part 1: Precision of ventilation.
Johannes Spaeth1, Malte Trost, Bernd Flamm
1Department of Anesthesiology and Critical Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
Anesthesiology
|May 13, 2026
Summary
Precision of mechanical ventilation in children varies by anesthesia workstation and mode. Pressure-controlled ventilation generally offers superior accuracy and leakage compensation compared to volume-controlled ventilation, especially for preterm infants and neonates.
Area of Science:
- Pediatric Anesthesiology
- Respiratory Care
- Biomedical Engineering
Background:
- Mechanical ventilation in children presents unique challenges for anesthesia workstations.
- Different ventilator technologies possess distinct pneumatic characteristics.
- The precision of delivered ventilation parameters may be influenced by the ventilator type.
Purpose of the Study:
- To evaluate the precision of delivered ventilation parameters across different modern anesthesia workstations.
- To compare the performance of volume-controlled versus pressure-controlled ventilation modes.
- To assess the impact of airway leakage on ventilation precision in pediatric models.
Main Methods:
- Six modern anesthesia workstations were tested using physical models simulating pediatric respiratory systems (preterm baby, neonate, infant, toddler).
- Volume-controlled and pressure-controlled ventilation were assessed with and without simulated airway leakage.
- Delivered tidal volume, peak inspiratory pressure, positive end-expiratory pressure, and inspiratory to expiratory ratio were compared to set values.
Main Results:
- Deviations in tidal volume during volume-controlled ventilation were significant, particularly in smaller lung models.
- Pressure-controlled ventilation demonstrated good agreement between set and delivered positive end-expiratory pressure and peak inspiratory pressure.
- Airway leakage resulted in lower delivered tidal volumes, with a more pronounced effect in volume-controlled ventilation.
Conclusions:
- Ventilation precision varies among modern anesthesia workstations, depending on ventilator type, mode, and settings.
- Pressure-controlled ventilation showed advantages in accuracy and leakage compensation across the tested workstations.
- Pressure-controlled ventilation is suggested to be superior to volume-controlled ventilation for preterm infants and neonates regarding ventilation precision.
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