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

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.

Keywords
Mean airway pressure, Mechanical ventilation, Oxygenation, Pediatric, Pressure-regulated volume-controlled ventilation