Comparison of Mechanical Power Calculations of Volume Control and Pressure Control Modes

Bakirkoy Dr. Sadi Konuk Training and Research Hospital

Status: Completed

Conditions: Ventilator-Induced Lung Injury

Treatments: Device: Changing mechanical ventilation mode

Study type: Observational

Funder types: Other

Identifiers

NCT05494554

2019-02-23

Details and patient eligibility

About

The management of ARDS, which is one of the important problems of intensive care patients, has gained popularity with the pandemic. Mechanical ventilation is an important life-saving treatment in ARDS patients. However, when not used correctly, it can cause Ventilator-Induced Lung Injury (VILI). Therefore, lung protective ventilation should be applied to minimize VILI in ARDS patients. Mechanical power is one of the parameters that guides intensivist in predicting VILI.

Full description

The goal of mechanical ventilation in ARDS patients is to improve oxygenation by reducing the work of breathing . With this aim, the orientation towards sensitive ventilation strategies has increased in the light of experience and scientific data from the past to the present. Today, the concept of Mechanical Power (MP) has been developed, which combines different variables, such as tidal volume, drive pressure, gas flow, respiratory rate, and PEEP, which have been associated with VILI in various studies, into a single parameter. In this study, the investigators used the simplified MP equation (MPvcv (simpl)) developed by Gattinoni et al. for power calculation in volume control mode and the simplified MP equation (MPpcv(simpl)) developed by Becher et al. for power calculation in pressure control mode. Thus, the investigators aimed to compare the volume control and pressure control modes over the concept of MP.

Enrollment: 36 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with confirmed Covid-19 diagnosis in intensive care unit (ICU) and diagnosed with ARDS according to Berlin criteria
• Intubated patients which treated in the supine position on the second day of ICU admission

Exclusion criteria

• Patients with a known diagnosis of COPD
• Patients experiencing hemodynamic instability during ventilation
• Prone pozisyonda olan hastalar
• Patients receiving inotropic support
• Patients with missing data

Trial design

36 participants in 2 patient groups

Pressure control mode group

Description:

On the 2nd day of intensive care hospitalization, while under deep sedation and in the controlled mode (VCV or PRVC) and in the supine position, the ventilator in the VCV mode was switched to PRVC mode for 60 minutes without changing any of the set ventilator settings (RR, PEEP, TV, I:E ratio).

Treatment:

Device: Changing mechanical ventilation mode

Volume control mode group

Description:

Likewise, if it is in PRVC mode, it is also switched to VCV mode for 60 minutes. In this way, two dependent groups were formed.

Treatment:

Device: Changing mechanical ventilation mode