Document Detail


The effects of pressure control versus volume control assisted ventilation on patient work of breathing in acute lung injury and acute respiratory distress syndrome.
MedLine Citation:
PMID:  10980100     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patient work of breathing (WOB) during assisted ventilation is reduced when inspiratory flow (V(I)) from the ventilator exceeds patient flow demand. Patients in acute respiratory failure often have unstable breathing patterns and their requirements for V(I) may change from breath to breath. Volume control ventilation (VCV) traditionally incorporates a pre-set ventilator V(I) that remains constant even under conditions of changing patient flow demand. In contrast, pressure control ventilation (PCV) incorporates a variable decelerating flow wave form with a high ventilator V(I) as inspiration commences. We compared the effects of flow patterns on assisted WOB during VCV and PCV. METHODS: WOB was measured with a BICORE CP-100 monitor (incorporating a Campbell Diagram) in a prospective, randomized cross-over study of 18 mechanically ventilated adult patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Tidal volume, inspiratory time, and mean ventilator V(I) were constant in each mode. RESULTS: At comparable levels of respiratory drive and minute ventilation, patient WOB was significantly lower with PCV than with VCV (0.59 +/- 0.42 J/L vs 0.70 +/- 0.58 J/L, respectively, p < 0.05). Ventilator peak V(I) was significantly higher with PCV than with VCV (103.2 +/- 22.8 L/min vs 43.8 L/min, respectively, p < 0.01). CONCLUSIONS: In the setting of ALI and ARDS, PCV significantly reduced patient WOB relative to VCV. The decrease in patient WOB was attributed to the higher ventilator peak V(I) of PCV.
Authors:
R H Kallet; A R Campbell; J A Alonso; D J Morabito; R C Mackersie
Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Respiratory care     Volume:  45     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-10-02     Completed Date:  2000-11-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1085-96     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, University of California, San Francisco General Hospital, 94110, USA. richkallet@earthlink.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cross-Over Studies
Esophagus / physiopathology
Female
Humans
Male
Middle Aged
Prospective Studies
Randomized Controlled Trials as Topic
Respiration, Artificial / methods*
Respiratory Distress Syndrome, Adult / etiology,  physiopathology*,  therapy*
Work of Breathing*
Comments/Corrections
Erratum In:
Respir Care. 2000 Nov;45(11):1416

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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