Is pressure-regulated volume control mode appropriate for severely obstructed patients?

Medina, Alberto; Modesto-Alapont, Vicent; Lobete, Carlos; Vidal-Micó, Silvia; Álvarez-Caro, Francisco; Pons-Òdena, Martí; Mayordomo-Colunga, Juan; Ibiza-Palacios, Emili

doi:10.1016/j.jcrc.2014.07.006

Cited by 8 publications

(7 citation statements)

References 14 publications

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“…There are no outcome data to recommend on any ventilatory or respiratory assist modes for children with or without lung pathology, cardiac children, or chronically ventilated children requiring escalation of support for acute exacerbations [ 2 , 54 – 59 ]. Ventilator mode should be dictated by clinical experience and theoretical arguments, considering the pathophysiology of the disease [ 60 , 61 ].…”

Section: Ventilator Modesmentioning

confidence: 99%

Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC)

Kneyber¹,

Luca²,

Calderini³

et al. 2017

Intensive Care Med

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244

191

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PurposeMuch of the common practice in paediatric mechanical ventilation is based on personal experiences and what paediatric critical care practitioners have adopted from adult and neonatal experience. This presents a barrier to planning and interpretation of clinical trials on the use of specific and targeted interventions. We aim to establish a European consensus guideline on mechanical ventilation of critically children.MethodsThe European Society for Paediatric and Neonatal Intensive Care initiated a consensus conference of international European experts in paediatric mechanical ventilation to provide recommendations using the Research and Development/University of California, Los Angeles, appropriateness method. An electronic literature search in PubMed and EMBASE was performed using a combination of medical subject heading terms and text words related to mechanical ventilation and disease-specific terms.ResultsThe Paediatric Mechanical Ventilation Consensus Conference (PEMVECC) consisted of a panel of 15 experts who developed and voted on 152 recommendations related to the following topics: (1) general recommendations, (2) monitoring, (3) targets of oxygenation and ventilation, (4) supportive measures, (5) weaning and extubation readiness, (6) normal lungs, (7) obstructive diseases, (8) restrictive diseases, (9) mixed diseases, (10) chronically ventilated patients, (11) cardiac patients and (12) lung hypoplasia syndromes. There were 142 (93.4%) recommendations with “strong agreement”. The final iteration of the recommendations had none with equipoise or disagreement.ConclusionsThese recommendations should help to harmonise the approach to paediatric mechanical ventilation and can be proposed as a standard-of-care applicable in daily clinical practice and clinical research.Electronic supplementary materialThe online version of this article (doi:10.1007/s00134-017-4920-z) contains supplementary material, which is available to authorized users.

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Section: Ventilator Modesmentioning

confidence: 99%

Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC)

Kneyber¹,

Luca²,

Calderini³

et al. 2017

Intensive Care Med

Self Cite

244

191

View full text Add to dashboard Cite

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“…However, mean ICP and PaCO 2 were not different between the two groups. [11] Although in an experimental work using ventilation simulations, using PRVC mode was not considered to provide appropriate TVs for severely obstructed patients;[12] in other situations such as postcardiac surgical patients, oxygenation index has been superior in PRVC mode of ventilation in recovery period. [13] Other pressure modes of mechanical ventilation may have better patient-ventilator synchrony and adequate gas exchange and less ventilator-induced lung injury.…”

Section: Discussionmentioning

confidence: 99%

Comparison of respiratory and hemodynamic stability in patients with traumatic brain injury ventilated by two ventilator modes: Pressure regulated volume control versus synchronized intermittent mechanical ventilation

2016

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Background:This study aimed to compare pressure regulated volume control (PRVC) and synchronized intermittent mechanical ventilation (SIMV) modes of ventilation according to respiratory and hemodynamic stability in patients with traumatic brain injury (TBI) admitted to Intensive Care Unit (ICU).Materials and Methods:In a randomized, single-blinded, clinical trial study, 100 patients who hospitalized in ICU due to TBI were selected and randomly divided into two groups. The first and second groups were ventilated by PRVC and SIMV modes, respectively. During mechanical ventilation, arterial blood gas and respiratory and hemodynamic parameters were also recorded and compared between the two groups.Results:According to the t-test, the mean rapid shallow breathing index (RSBI) after the first 8 h of mechanical ventilation was significantly higher in SIMV group compared with PRVC group (107.6 ± 2.75 vs. 102.2 ± 5.2, respectively, P < 0.0001). Further, according to ANOVA with repeated measures, the trend of RSBI changes had a significant difference between the two groups (P < 0.001). The trend of ratio of partial pressure arterial oxygen and fraction of inspired oxygen was different between the two groups according to Mann–Whitney–Wilcoxon test (P < 0.001).Conclusions:Using PRVC mode might be more desirable than using SIMV mode in patients with TBI due to better stability of ventilation and oxygenating. To ensure for more advantages of PRVC mode, further studies with longer follow-up and more detailed measurements are recommended.

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“…Comparison of pressure-control mode and pressure-control mode for preoxygenation shows that pressure-control mode is able to ensure ventilator capacity and also can facilitate earlier related interventions to airway obstruction or leakage in breathing loop, which may affect ventilation [ 29 ] ; while the ventilator capacity of pressure control mode is affected by many factors, such as airway condition, thorax and lung compliance, and others, and pressure-control mode has a relatively low sensitiveness to airway obstruction or leakage in breathing loop. Therefore, application of invasive ventilator for preoxygenation can more effectively ensure ventilator capacity and increase oxygen/nitrogen ratio in pulmonary functional residual capacity and can rapidly improve oxygenation in patients with acute critical illness, thereby providing more time for further life support.…”

Section: Discussionmentioning

confidence: 99%

Preoxygenation using invasive ventilator in volume control mode in patients with emergency intubation can shorten the time of preoxygenation and improve the quality of preoxygenation

Wang

Sun²,

Bai³

et al. 2016

Medicine

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Preoxygenation can rapidly improve oxygenation and enhance the security of endotracheal intubation, so it is very essential before endotracheal intubation. The conventional preoxygenation method self-inflating bag (SIB) is not very effective in case of emergency. So our study aims to find a more effective method of preoxygenation in a critical situation.We retrospectively analyzed data of 105 patients in this study. A total of 49 patients with preoxygenation with invasive ventilator in volume control mode (VCM) and 56 patients with preoxygenation with SIB were included. No significant differences were detected in the baseline data of the 2 groups (P > 0.05). Time of preoxygenation (95%) was 174 (168–180) seconds in group VCM and 205 (199–212) seconds in group SIB (P < 0.05), and multifactor linear regression showed that its main risk factors were the methods of preoxygenation and PO2 before preoxygenation (P < 0.05). Immediate SPO2 after preoxygenation was 91 (89–92)% in group VCM and 85 (83–86)% in group SIB (P < 0.05). Total time of preoxygenation and intubation was 266 (252–280) seconds in group VCM and 318 (298–338) seconds in group SIB (P < 0.05). The 24-hour and overall survival rate in group SIB were lower than in group VCM (P > 0.05). Cox regression showed that SaO2 at 5 minutes after intubation was the major risk factor for the survival rate.Invasive ventilator with volume control mode can shorten the time of preoxygenation and improve the quality of preoxygenation in patients with emergency intubation and may be a better method of preoxygenation in a critical situation.

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Is pressure-regulated volume control mode appropriate for severely obstructed patients?

Cited by 8 publications

References 14 publications

Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC)

Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC)

Comparison of respiratory and hemodynamic stability in patients with traumatic brain injury ventilated by two ventilator modes: Pressure regulated volume control versus synchronized intermittent mechanical ventilation

Preoxygenation using invasive ventilator in volume control mode in patients with emergency intubation can shorten the time of preoxygenation and improve the quality of preoxygenation

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