Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?

Ahmet YÜKSEK, (Sağlık Bilimleri Üniversitesi, Kocaeli Derince Eğitim ve Araştırma Hastanesi, Kocaeli, Türkiye)
Ökkeş Hakan MİNİKSAR, (Yozgat Bozok Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yozgat, Türkiye)
Cevdet YARDIMCI, (Yozgat Bozok Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yozgat, Türkiye)
Aysegul PARLAK CIKRIKCI (Yozgat Bozok Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yozgat, Türkiye)
Anestezi Dergisi
4 1
Yıl: 2022 Cilt: 30 Sayı: 4 Sayfa Aralığı: 232 - 239 Metin Dili: İngilizce DOI: 10.54875/jarss.2022.83713 İndeks Tarihi: 02-11-2022

Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?

Öz:
Mechanical power (MP) is the amount of energy transferred to the respiratory system of patients during each breath period. After overcoming the resistances required for respiration, the remaining energy may end up by damaging the lung parenchyma. The MP limit that should not be exceeded in pediatric patients is not yet clear. The aim of this observational descriptive study is to compare the perioperative MP measurements in healthy pediatric cases with the values given in the literature. Methods: Perioperative MP was calculated according to the simplified MP formula in pediatric patients without known lung disease and compared with the literature. Results: The mean age of 34 patients was 68.88±31.4 months and the mean weight was 21.82±7.5 kg. The mean MP was 3.93±1.1 J min-1, and the indexed MP was 0.19±0.08 J min-1 kg-1. Both MP (p=0.008) and indexed MP (p<0.001) were significantly higher in patients with high tidal volume. In addition, we found a negative correlation between indexed MP and weight (r: -668 and p<0.001). Both MP and indexed MP had sufficient predictive power to predict tidal volume >10 and predictive value was significant [Auc: 0.764, 95%CI: 0.55-0.97, p: 0.026]. The value of MP>3.76 was an indicator for tidal volume >10 with 87 sensitivity and 50 specificity. Predictive value of indexed MP for tidal volume >10 mL kg-1 was 0.25 J kg-1 [AUC 0.856, 95%CI: 0.70-1.0, p=0.003], and indexed MP was a stronger indicator than MP. Conclusion: This study revealed that MP threshold values calculated for adults or patients with ARDS lung are not sensitive for pediatric patients, and a new threshold value should be determined for these patients.
Anahtar Kelime:

Pediyatrik Hastalarda Güvenlik Önlemi Olarak Mekanik Güç Kullanılabilir mi?

Öz:
Mekanik güç (MP), her nefes döngüsünde hastaların solunum sistemine aktarılan enerji miktarıdır. Solunum için gerekli olan dirençler aşıldıktan sonra kalan enerji akciğer parankimine zarar vererek sonlanabilir. Pediatrik hastalarda aşılmaması gereken MP sınırı henüz netlik kazanmamıştır. Bu gözlemsel tanımlayıcı çalışmanın amacı, sağlıklı pediatrik olgularda perioperatif MP ölçümlerini literatürde verilen değerlerle karşılaştırmaktır. Yöntem: Perioperatif MP, bilinen akciğer hastalığı olmayan pediatrik hastalarda basitleştirilmiş MP formülüne göre hesaplandı ve literatürle karşılaştırıldı. Bulgular: 34 hastanın yaş ortalaması 68.88±31.4 ay ve ortalama ağırlık 21.82±7.5 kg idi. Ortalama MP 3,93±1,1 J dak-1 ve indekslenmiş MP 0,19±0,08 J dak-1 kg-1 idi. Hem MP (p=0,008) hem de indekslenmiş MP (p<0,001) tidal hacmi yüksek olan hastalarda anlamlı olarak daha yüksekti. Ayrıca indekslenen MP ile ağırlık (r: -668 ve p<0.001) arasında negatif korelasyon bulduk. Hem MP hem de indekslenmiş MP, tidal hacmi >10 tahmin etmek için yeterli tahmin gücüne sahipti ve tahmin değeri anlamlıydı [Auc: 0.764, %95 CI: 0.55-0.97, p: 0.026]. MP>3.76 değeri, 87 duyarlılık ve 50 özgüllük ile >10 tidal hacim için bir göstergeydi. >10 mL kg-1 tidal hacim için indekslenmiş MP’nin tahmin değeri 0.25 J kg-1 [AUC 0.856, %95 CI: 0.70-1.0, p=0.003] idi ve indekslenmiş MP, MP’den daha güçlü bir gösterge idi. Sonuç: Bu çalışma, yetişkinler veya ARDS akciğeri olan hastalar için hesaplanan MP eşik değerlerinin çocuk hastalar için hassas olmadığını ve bu hastalar için yeni bir eşik değerinin belirlenmesi gerektiğini ortaya koymuştur.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA yüksek a, Miniksar Ö, YARDIMCI C, A (2022). Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?. , 232 - 239. 10.54875/jarss.2022.83713
Chicago yüksek ahmet,Miniksar Ökkeş Hakan,YARDIMCI CEVDET, AYŞEGÜL Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?. (2022): 232 - 239. 10.54875/jarss.2022.83713
MLA yüksek ahmet,Miniksar Ökkeş Hakan,YARDIMCI CEVDET, AYŞEGÜL Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?. , 2022, ss.232 - 239. 10.54875/jarss.2022.83713
AMA yüksek a,Miniksar Ö,YARDIMCI C, A Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?. . 2022; 232 - 239. 10.54875/jarss.2022.83713
Vancouver yüksek a,Miniksar Ö,YARDIMCI C, A Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?. . 2022; 232 - 239. 10.54875/jarss.2022.83713
IEEE yüksek a,Miniksar Ö,YARDIMCI C, A "Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?." , ss.232 - 239, 2022. 10.54875/jarss.2022.83713
ISNAD yüksek, ahmet vd. "Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?". (2022), 232-239. https://doi.org/10.54875/jarss.2022.83713
APA yüksek a, Miniksar Ö, YARDIMCI C, A (2022). Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?. Anestezi Dergisi, 30(4), 232 - 239. 10.54875/jarss.2022.83713
Chicago yüksek ahmet,Miniksar Ökkeş Hakan,YARDIMCI CEVDET, AYŞEGÜL Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?. Anestezi Dergisi 30, no.4 (2022): 232 - 239. 10.54875/jarss.2022.83713
MLA yüksek ahmet,Miniksar Ökkeş Hakan,YARDIMCI CEVDET, AYŞEGÜL Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?. Anestezi Dergisi, vol.30, no.4, 2022, ss.232 - 239. 10.54875/jarss.2022.83713
AMA yüksek a,Miniksar Ö,YARDIMCI C, A Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?. Anestezi Dergisi. 2022; 30(4): 232 - 239. 10.54875/jarss.2022.83713
Vancouver yüksek a,Miniksar Ö,YARDIMCI C, A Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?. Anestezi Dergisi. 2022; 30(4): 232 - 239. 10.54875/jarss.2022.83713
IEEE yüksek a,Miniksar Ö,YARDIMCI C, A "Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?." Anestezi Dergisi, 30, ss.232 - 239, 2022. 10.54875/jarss.2022.83713
ISNAD yüksek, ahmet vd. "Can Mechanical Power be Used as a Safety Precaution in Pediatric Patients?". Anestezi Dergisi 30/4 (2022), 232-239. https://doi.org/10.54875/jarss.2022.83713
Sayfa Oluşturulma Tarihi
24-04-2024 4:25

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