The effect of switching from volume-controlled to pressure-controlled ventilation on respiratory distress and asynchrony index improvement among mechanically ventilated adults

Authors
Mahmoud Saghaei 1
Saeed Abbasi 2
Babak Alikiaii 2
Sayed Hamid Pakzad Moghadam 3
1 Department of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Anesthesiology, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Anesthesiology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
Abstract
Background: It is important to synchrony the time, intensity, and respiratory signal of the phrenic nerve between the patient and the ventilator. This study aimed to evaluate the effect of switching from volume-controlled to pressure-controlled ventilation on respiratory distress and asynchrony index improvement.
Materials and Methods: In this randomized controlled clinical trial, 70 patients admitted to the intensive care unit under mechanical ventilation were included. Asynchronous evaluation was performed by examining the patient and evaluating and analyzing the graphic flow curve and ventilator pressure, which included trigger and flow asynchronous and asynchronous cycling. In the intervention group, the mode of ventilation was switched to PSIMV such that peak inspiratory pressures would be equivalent to positive end-expiratory pressure (PEEP) in the volume-controlled mode. Finally, again at 60, 75, and 90 min, information about the ventilator and the patient's symptoms, and arterial carbon dioxide levels were sent by arterial gas sample. The asynchronous index was also recorded in both groups.
Results: This study showed that the mean of variables such as height, ideal body weight, tidal volume, set rate; Sense, FiO2, PEEP did not differ significantly between the two groups. The mean of asynchrony was significantly reduced in both control group (16.51 ± 3.35–14.51 ± 2.90; P < 0.001) and intervention group (18.26 ± 6.13–13.32 ± 5.53; P < 0.001).
Conclusion: Regardless of the type and severity of the disease, switching the ventilation mode from volume-controlled to pressure-controlled can improve patient adaptation to the ventilator, especially in cases with frequent asynchrony.

Keywords

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Advanced Biomedical Research
Volume 2023, February
February 2023
Pages 1-6