Comparison between Pressure Regulated Volume Control Ventilation and Synchronized Intermittent Mandatory Ventilation in Acute Exacerbations of Chronic Obstructive Pulmonary Disease
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- Category: Vol. 84, December 2016
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Comparison between Pressure Regulated Volume Control Ventilation and Synchronized Intermittent Mandatory Ventilation in Acute Exacerbations of Chronic Obstructive Pulmonary Disease, EISA I. AFIFY, AHMED T. SHAARAWY, AHMED E. KABIL and MAGDY S. TAHA
Abstract
Objective: The aim of this study was to to evaluate and compare the outcome of PRVC ventilation mode versus SIMV in the management of acute exacerbation of COPD requiring mechanical ventilation.
Patients and Methods: The study included 70 consecutive patients presented with acute exacerbation of COPD who were indicated for invasive mechanical ventilation. Patients were randomly assigned into two groups, group I, which included 35 patients who were ventilated using PRVC mode, and group II, which included 35 patients who were ventilated using SIMV mode.
All patients were subjected to thorough history taking, clinical examination, routine laboratory investigations, chest X-ray, ECG and blood gasses analysis. Ventilatory parameters after 24 hours of ventilation and outcomes were recorded in both groups.
Results: After 24 hours of mechanical ventilation, Pa CO2 was significantly improved in group I than in group II. There was improvement in O2 saturation and Pa O2 in group I compared to group II but without statistically significant difference. Peak Inspiratory Pressure (PIP) and Respiratory Rate (RR) were significantly lower in group I than in group II patients. Minute Ventilation (MV) was significantly higher in group I than group II patients. Unwanted/adverse outcomes and mortality were lower with PRVC mode than SIMV mode but without a statistically significant difference between both groups.
Conclusions: PRVC mode appears to be superior to SIMV mode in ventilating COPD patients with acute exacerbations with a significantly lower peak inspiratory pressure and more effective ventilation.