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

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Krishan Chugh
2. Shruti Agarwal
3. Anil Sachdev
ISSN
0972-5229
DOI
10.4103/0972-5229.19760
Volume
9
Issue
4
Publishing Year
2005
Pages
6
Author Affiliations
    1. Sir Ganga Ram Hospital, New Delhi
    2. Sir Ganga Ram Hospital, Delhi, India
    3. Sir Gangaram Hospital, New Delhi, India
    4. Child Health, Sir Ganga Ram Hospital, New Delhi, India
    5. Sir Ganga Ram Hospital, New Delhi, e-mail: chughk@bol.net.in
    6. Centre for Child Health, Sir Ganga Ram Hospital, New Delhi
    7. Sir Ganga Ram Hospital, New Delhi, India
    8. Institute of Health, Sir Ganga Ram Hospital, New Delhi
    9. Fortis Memorial Research Institute, Gurgaon, Haryana, India
    10. SGR Hospital, New Delhi, India
    11. Fortis Memorial Research Institute, Gurugram, Haryana, India
    1. Department of Pediatrics, Center for Child Health, Sir Ganga Ram Hospital, New Delhi, India
    1. Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110 060, India
  • Article keywords
    Mean airway pressure, Mechanical ventilation, Oxygenation, Pediatric, Pressure-regulated volume-controlled ventilation

    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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