Egyptian Journal of Chest Disease and Tuberculosis (Jan 2016)

Pressure regulated volume controlled ventilation versus synchronized intermittent mandatory ventilation in COPD patients suffering from acute respiratory failure

  • Ahmed Abd El-Rahman Ali,
  • Rabab Abd El-Razik El Wahsh,
  • Mohammed Abd El-Sattar Agha,
  • Bishoy Berzy Tawadroos

DOI
https://doi.org/10.1016/j.ejcdt.2015.08.004
Journal volume & issue
Vol. 65, no. 1
pp. 121 – 125

Abstract

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Background: Volume controlled ventilation (VC) allows a set tidal volume to be guaranteed but it causes excessive airway pressures that may lead to barotrauma. Pressure controlled ventilation (PC) limits ventilator-induced lung injury but has a disadvantage of variable tidal volume delivery. Pressure-regulated volume controlled ventilation is a kind of dual-control ventilation that combines the advantages of both volume controlled and pressure controlled ventilation. Objective: To compare the pressure regulated volume controlled ventilation (PRVC) versus traditional synchronized intermittent mandatory ventilation (SIMV) in chronic obstructive pulmonary disease (COPD) patients suffering from acute respiratory failure. Patients and methods: This prospective study was carried on 30 COPD patients suffering from acute respiratory failure, divided in two groups: group 1 patients were ventilated using the SIMV mode and group 2 patients were ventilated using the PRVC mode. The arterial blood gas (ABG) parameters, ventilation data, complications and prognosis were compared in the two groups. Results: The ABG parameters improved better in the PRVC group after 6 and 48 h. The peak inspiratory pressure (PIP) values were lower in the PRVC group. There were fewer complications (33% in group 2 versus 86% in group 1). The prognosis was better in PRVC group as 13 patients (86%) were weaned, 1 patient (7%) died and 1 patient (7%) failed to be weaned. On the other hand, 6 patients (40%) were weaned, 3 patients (20%) died and 6 patients (40%) failed to be weaned in the SIMV group. Conclusion: The PRVC mode is better than the volume controlled SIMV mode in ventilating COPD patients with acute exacerbations and type II respiratory failure.

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