Neeraj Gupta¹, Swasthi Kabisatpathy¹
1- Department of Neonatology, AIIMS, Jodhpur, India
Abstract Body
Introduction: Mean airway pressure (MAP) is central to oxygenation and lung recruitment in mechanically ventilated neonates. Conventional MAP calculation using standard formula is physiologically sound but requires inspiratory and expiratory time variables apart from pressures (PIP & PEEP), making bedside mental calculation impractical.
Objectives:
PRIMARY: To determine agreement between a ‘novel simplified MAP formula (Gupta’s formula)’ and the ‘conventional formula’.
SECONDARY: To compare the ‘novel simplified MAP formula’ with ‘ventilator-displayed MAP’.
Methods: This crosssectional study was conducted in a level-III NICU in western Rajasthan, India from Jan,2025 till Jan,2026 among neonates receiving pressure-controlled invasive ventilation. Neonates on high-frequency or volume-guarantee modes, with significant air leaks or chest tubes were excluded. Paired MAP measurements were recorded during stable ventilation using the ‘conventional formula’, ‘novel simplified formula’, and ‘ventilator-displayed MAP’. Agreement was evaluated using Bland–Altman analysis.
Results: Ninety-nine neonates contributed 120 paired observations. Mean gestational age and birthweight was 33(3) weeks and 1889(947) grams respectively . Mean MAP was 8.74 ± 1.63 cmH₂O using the simplified formula and 8.37 ± 1.62 cmH₂O using the conventional formula. Mean bias was 0.37 cmH₂O with narrow limits of agreement (95%CI: −0.26 to 1.00 cmH₂O) and strong correlation (r = 0.98;p < 0.001). When compared with ventilator-displayed MAP values, the novel simplified formula demonstrated a mean bias of 0.38 cmH₂O (95% CI: −0.81 to 1.57 cmH₂O and strong correlation (r = 0.91p < 0.001).
Conclusions: This is the first of it’s time-independent MAP formula which offers a rapid, bedsidefriendly estimate of MAP for routine neonatal ventilation management.