| Autor: |
Anoopindar K. Bhalla, Margaret J. Klein, Vicent Modesto I Alapont, Guillaume Emeriaud, Martin C. J. Kneyber, Alberto Medina, Pablo Cruces, Franco Diaz, Muneyuki Takeuchi, Aline B. Maddux, Peter M. Mourani, Cristina Camilo, Benjamin R. White, Nadir Yehya, John Pappachan, Matteo Di Nardo, Steven Shein, Christopher Newth, Robinder Khemani, Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Critical Care, Vol 26, Iss 1, Pp 1-12 (2022) |
| Druh dokumentu: |
article |
| ISSN: |
1364-8535 |
| DOI: |
10.1186/s13054-021-03853-6 |
| Popis: |
Abstract Background Mechanical power is a composite variable for energy transmitted to the respiratory system over time that may better capture risk for ventilator-induced lung injury than individual ventilator management components. We sought to evaluate if mechanical ventilation management with a high mechanical power is associated with fewer ventilator-free days (VFD) in children with pediatric acute respiratory distress syndrome (PARDS). Methods Retrospective analysis of a prospective observational international cohort study. Results There were 306 children from 55 pediatric intensive care units included. High mechanical power was associated with younger age, higher oxygenation index, a comorbid condition of bronchopulmonary dysplasia, higher tidal volume, higher delta pressure (peak inspiratory pressure—positive end-expiratory pressure), and higher respiratory rate. Higher mechanical power was associated with fewer 28-day VFD after controlling for confounding variables (per 0.1 J·min−1·Kg−1 Subdistribution Hazard Ratio (SHR) 0.93 (0.87, 0.98), p = 0.013). Higher mechanical power was not associated with higher intensive care unit mortality in multivariable analysis in the entire cohort (per 0.1 J·min−1·Kg−1 OR 1.12 [0.94, 1.32], p = 0.20). But was associated with higher mortality when excluding children who died due to neurologic reasons (per 0.1 J·min−1·Kg−1 OR 1.22 [1.01, 1.46], p = 0.036). In subgroup analyses by age, the association between higher mechanical power and fewer 28-day VFD remained only in children |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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