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VOLUME 9 , ISSUE 4 ( October, 2005 ) > List of Articles

ORIGINAL ARTICLE

Comparision of two ventilation modes and their clinical implications in sick children

Krishan Chugh, Anil Sachdev, Shruti Agarwal

Keywords : Mean airway pressure, Mechanical ventilation, Oxygenation, Pediatric, Pressure-regulated volume-controlled ventilation

Citation Information : Chugh K, Sachdev A, Agarwal S. Comparision of two ventilation modes and their clinical implications in sick children. Indian J Crit Care Med 2005; 9 (4):205-210.

DOI: 10.4103/0972-5229.19760

License: CC BY-ND 3.0

Published Online: 01-04-2010

Copyright Statement:  Copyright © 2005; The Author(s).


Abstract

Objective: To compare the ventilation parameters of conventional, volume-controlled (VC), and pressure-regulated volume-controlled modes in sick children with varying lung disease, the effects of specific mode on ventilation-related complications and patient outcome, and improvement in oxygenation with any specific mode. Design: Retrospective case record analysis. Setting: Seven-bedded tertiary-care pediatric intensive care unit in North India. Patients: Twenty-eight ventilated children admitted from July to December 2000. Intervention: None. Measurements and Main Results: Twenty-eight patients were studied with equal number in VC and pressure-regulated (PR) VC groups. The demographic profile, as well as preventilation and on ventilator blood-gas analysis were comparable in the two groups. Mean airway pressure in PRVC group was 17.5% lower as compared with that in VC group (P = 0.03). Similarly, preventilation PaO2 (65 ± 17 mmHg), PaO2/FiO2 (121 ± 41 mmHg), and respiratory index (RI) (4.91 ± 2.7) improved significantly (P< 0.05) with PRVC ventilation (PaO2 = 99 ± 25 mmHg, PaO2/FiO2 = 183 ± 8 mmHg, RI = 3.36±2.95) and not in VC ventilation group. There was no difference in duration of ventilation, ventilator-related complications, and patient outcome in the two groups. Conclusion: PRVC ventilation is beneficial and improves oxygenation in initial stages of ventilation.


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  1. Marrow AG. Innovative practices of ventilatory support with pediatric patients. Pediatric Crit care Med 2003;4:8-20.
  2. Kucmorek R, Custer JR, Fugate JH. Mechanical ventilation In Critical care of infants and children. Ed. Todres ID, Fugate JH. Little Browne and Company: New York; 1996. p. 155-82.
  3. Apostolacos MJ, Levy PC, Papdakos PJ. New modes of mechanical ventilation. Clin Pulm Med 1995;2:121-8.
  4. Kocis KC, Dekeon MK, Rosen HK, Bandy KP, Crowley DC, Bove EL, et al. Pressure regulated volume control vs. volume control ventilation in infants after surgery for congenital heart disease. Pediatr cardiol 2001;22:233-7.
  5. Piotrowski A, Sobala W, Kawczynski P. Patient-initiated pressure regulated volume controlled ventilation compared with intermittent mandatory ventilation in neonates: a prospective randomized study. Intensive Care Med 1997;23:975-81.
  6. Pollack MM, Patel KM, Ruttimann UE. Prism III: an updated Pediatric Risk of Mortality Score. Crit Care Med 1996;24:743-52.
  7. Gowda MS, Klocke RA. Variability of indices of hypoxemia in adult respiratory distress syndrome. Crit Care Med 1997;25:41-5
  8. Servo ventilator 300/300A- operating manual 8.0/9.0 Siemen- Elema AB, Electromedical Systems Division, S- 171 95 Solna, Sweden.
  9. Abraham E, Yoshihara G. Cardiorespiratory effects of pressure controlled ventilation in severe respiratory failure. Chest 1990;98:1445-9.
  10. Davis K, Branson DR, Campbell RS, Porembka DT. Comparison of volume control and pressure control ventilation: Is flow waveform the difference? J Trauma 1996;41:808-14
  11. Al-Saddy N, Bennett E. Decelerating inspiratory flow waveform improves lung mechanics and gas exchange in patients on intermittent positive pressure ventilation. Intensive Care lMed 1985;11:68-75.
  12. Rappaport SH, Shipner R, Yoshihara G, Wright J, Chang R, Abraham E. Randomized, prospective trial of pressure-limited versus volume controlled ventilation in severe Respiratory failure. Crit Care Med 1994;22:22-32.
  13. Guldager H, Nielsen SL, Carl P, Soerensen MB. A comparison of volume control and pressure regulated volume control ventilation in acute respiratory failure. Crit Care 1997;1:75-7.
  14. Broccard AF, Hotchkiss JR, Suzuki SO, Olson D, Marini JJ. Effects of mean airway pressure and tidal excursion on lung injury induced by mechanical ventilation in an isolated perfused rabbit lung model. Crit Care Med 1999;27:1533-41.
  15. Parker JC, Hernandez LA, Peevy KJ. Mechanisms of ventilator - induced lung injury. Crit Care Med 1993;21:131-43.
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