Pressure-Regulated Volume Control and Pressure-Control Ventilation Modes in Pediatric Acute Respiratory Failure
Turkish Journal of Anaesthesiology and Reanimation, cilt.50, sa.1, ss.18-23, 2022 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 50 Sayı: 1
- Basım Tarihi: 2022
- Doi Numarası: 10.5152/tjar.2021.1412
- Dergi Adı: Turkish Journal of Anaesthesiology and Reanimation
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.18-23
- Anahtar Kelimeler: Artificial respiration, pediatric intensive care units, positive-pressure respiration, respiratory insufficiency
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: The objective of this study is to present our experience using the pressure-regulated volume control and the pressure-control ventilation modes in children. Methods: Patients with acute respiratory failure ventilated with pressure-regulated volume control or pressure-control modes were retrospec-tively evaluated. The patient’s ventilation parameters (of the first 7 days of ventilation or of the whole ventilation period, if the patient had been ventilated less than 7 days), SpO2, blood gases, and demographic data were collected from the pediatric intensive care unit database. Results: Sixty-one patients (median age 12 [4.8-36.4] months) were enrolled in the study. The pressure-control ventilation mode was used on 40 patients (65.6%) and the pressure-regulated volume-control mode was used on 21 (34.4%) patients. Twenty-eight patients (45.9%) had hypoxemic respiratory failure and 44 (72.1%) had hypercapnic respiratory failure. The median positive end-expiratory pressure was higher in pressure-control ventilation mode (5.4 [4.2-6.3] cmH2 O) than the pressure-regulated volume-control mode (4.05 [3.68-4.41] H2 O, P <.001). Pressure-control mode was used more frequently in hypoxemic cases but both modes were used equally in hypercapnic cases. Hypoxic respiratory failure (yes/no), odds ratio: 3.9 (95% CI 1.2-12.3, P =.02), Ph (nadir), odds ratio: 0.004 (95% CI 0.000-0.275, P =.01), and base excess, odds ratio: 0.88 (95% CI 0.79-0.98, P =.02) were associated with intensive care mortality. Conclusions: Although the pressure-control ventilation mode was preferred more frequently in hypoxemic respiratory failure, there was no significant difference between the 2 respiratory modes in terms of length of pediatric intensive care unit stay, MV duration, and mortality. The pressure-regulated volume-control mode seems to be a safer option for physicians who do not have enough experience in using pressure-control ventilation mode.