Higher mechanical power (MP) was associated with fewer ventilator (VFD) and ICU free days (IFD). The causal effect of MP on VFD and IFD was fully mediated by the impairment in oxygenation.

This is a post-hoc analysis of data from a before-and-after study which recruited children with PARDS. We used a simplified MP calculation for pressure-controlled and volume-controlled ventilation normalized to predicted body weight.

We identified low, moderate and high MP cut-offs and used multivariable regression to determine the association between MP categories on intensive care unit (ICU) mortality, 28-day ventilator (VFD) and ICU free days (IFD) free days, adjusting for the Pediatric Index of Mortality 3 score, Pediatric Logistic Organ Dysfunction 2 score, oxygenation index (OI) and age.

Causal mediation analysis was performed to estimate the causal effect of MP on outcomes treating oxygenation impairment (represented by OI) as mediator and age as a confounder.

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