A comparison of ventilation techniques in ARDS. Volume controlled vs pressure regulated volume control

OBJECTIVE: Comparison between effects of a new method of mechanical ventilation (PRVC) and Volume Controlled ventilation in the ARDS treatment. DESIGN: Prospective study from March 1995 to March 1997. PLACE: Intensive Care Unit of Sanremo Hospital. PATIENTS: Nine patients, six males and three females, average age 49.2 years, average SAPS 35.5, with moderate to severe ARDS related to various etiologies. INTERVENTIONS: Patient were first ventilated with Siemens Servo Ventilators 300 in Volume controlled. They were then ventilated with Pressure-regulated Volume Control maintaining the same ventilation parameters (TV, RR, FiO2, PEEP and I:E ratio). MEASUREMENTS: After a 60 minute stabilisation period in each method, Peak inspiratory pressure, Static Compliance, PaO2, PaCO2, AaDO2 and cardiovascular parameters were measured. RESULTS: With the PRVC ventilation an important decrease of PIP and an improvement of PaO2 and SaO2 were observed. CONCLUSIONS: Although it is not possible to draw any conclusion on morbidity and mortality in patients treated with PRVC versus VC, for gas exchange and compliance improvement and for inspiratory pressure decrease with consequent reduction of barotrauma, it may be affirm that PCRV seems to be the best ventilation methods in the ARDS treatment.