What is Better in ARDS: Pressure Controlled or Volume Controlled Ventilation?

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A good question, but do you actually know. Most ICU’s have their standard modes of ventilation and we are busy enough concentrating on the wright PEEP, the perfect tidal volume or prone positioning the patient. But does the mode of ventilation actually have an impact on the outcome? Chacko et al. had a look at exactly this question and performed a systematic review on this topic:

– Early mortality: There is only some moderate-quality evidence suggesting that pressure controlled ventilation might be of benefit, although this was not observed in the long term follow-up!

– Duration of mechanical ventilation: no apparent difference between pressure- and volume-controlled ventilation

– ICU length of stay: no apparent difference between pressure- and volume-controlled ventilation

– incidence of barotrauma: no apparent difference between pressure- and volume-controlled ventilation

– Extrapulmonary organ failure: One underpowered study in favour of pressure controlled ventilation

– Infective complications, Quality of life: To this date no studies available

Conclusion: Current evidence shows no difference between pressure controlled and volume controlled ventilation in ARDS

 

Cochrane, Clinical Answers OPEN ACCESS

Chacko B, Peter JV, Tharyan P, John G, Jeyaseelan L. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD008807. OPEN ACCESS

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