Background: Mechanical power estimates the amount of energy delivered to ventilated lungs but there are no available data in neonates. We aim to provide a real-world description of power and investigate its relationship with clinical variables in neonates. Methods: Cross-sectional study enrolling neonates of any gestational age. Patients were classified as recovering from respiratory distress syndrome (RDS), affected by neonatal acute respiratory distress syndrome (ARDS), or with evolving broncho-pulmonary dysplasia (BPD). Simultaneously collected ventilation and oxygenation data as well as ultrasound-assessed lung aeration were used; power was calculated with four different equations. Results: 100 (55 males) neonates (32 with RDS, 30 with neonatal ARDS, 10 with evolving BPD and 28 controls with no lung disease) were studied. Distributions of power and energy (i.e. power for a single breath) for the whole population were given (median power ranging between 0.28 [0.18, 0.39] and 0.39 [0.29, 0.54] J/min/Kg, median energy ranging between 7.1 [4.9, 9.1] and 9.5 [6.8, 12.3] mJ/Kg). Median power (difference varying between 0.21 and 0.9 J/min/Kg (p always <0.001), depending on the used equation) and energy (difference varying between 0.9 and 3 mJ/Kg (p always <0.001), depending on the used equation) were higher in neonates with respiratory failure than in controls. Components of power due to dynamic and static strain showed similar differences. Power correlated with oxygenation (adj-ρ between 0.18 (95%CI: 0.02; 0.34) and 0.22 (95%CI: 0.06; 0.38), p varying between 0.032 and 0.045) and lung aeration impairment (ρ between 0.25 (95%: 0.07;0.41) and 0.27 (95%CI: 0.08; 0.43), p varying between 0.009 and 0.013, depending on the used equation). Conclusions: Mechanical power, its components due to dynamic and static strain, and energy are higher in neonates with respiratory disorders than in controls. Mechanical power and its components are correlated with impairment of oxygenation and lung aeration.
Mechanical power and energy in invasively ventilated newborn infants
Dellaca', Raffaele;
2026-01-01
Abstract
Background: Mechanical power estimates the amount of energy delivered to ventilated lungs but there are no available data in neonates. We aim to provide a real-world description of power and investigate its relationship with clinical variables in neonates. Methods: Cross-sectional study enrolling neonates of any gestational age. Patients were classified as recovering from respiratory distress syndrome (RDS), affected by neonatal acute respiratory distress syndrome (ARDS), or with evolving broncho-pulmonary dysplasia (BPD). Simultaneously collected ventilation and oxygenation data as well as ultrasound-assessed lung aeration were used; power was calculated with four different equations. Results: 100 (55 males) neonates (32 with RDS, 30 with neonatal ARDS, 10 with evolving BPD and 28 controls with no lung disease) were studied. Distributions of power and energy (i.e. power for a single breath) for the whole population were given (median power ranging between 0.28 [0.18, 0.39] and 0.39 [0.29, 0.54] J/min/Kg, median energy ranging between 7.1 [4.9, 9.1] and 9.5 [6.8, 12.3] mJ/Kg). Median power (difference varying between 0.21 and 0.9 J/min/Kg (p always <0.001), depending on the used equation) and energy (difference varying between 0.9 and 3 mJ/Kg (p always <0.001), depending on the used equation) were higher in neonates with respiratory failure than in controls. Components of power due to dynamic and static strain showed similar differences. Power correlated with oxygenation (adj-ρ between 0.18 (95%CI: 0.02; 0.34) and 0.22 (95%CI: 0.06; 0.38), p varying between 0.032 and 0.045) and lung aeration impairment (ρ between 0.25 (95%: 0.07;0.41) and 0.27 (95%CI: 0.08; 0.43), p varying between 0.009 and 0.013, depending on the used equation). Conclusions: Mechanical power, its components due to dynamic and static strain, and energy are higher in neonates with respiratory disorders than in controls. Mechanical power and its components are correlated with impairment of oxygenation and lung aeration.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
