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. 2020 Nov;21(4):305-311.
doi: 10.1177/1751143719878969. Epub 2019 Oct 21.

Use of pressure-regulated volume control in the first 48 hours of hospitalization of mechanically ventilated patients with sepsis or septic shock, with or without ARDS

Yuri Matusov  1   2 , Jing Li  3 , Dominique Resuello  3 , Hannah Mathers  4 , Jeffrey C Fried  5
Affiliations

Use of pressure-regulated volume control in the first 48 hours of hospitalization of mechanically ventilated patients with sepsis or septic shock, with or without ARDS

Yuri Matusov et al. J Intensive Care Soc. 2020 Nov.

Abstract

Purpose: To evaluate the impact of pressure-regulated volume control (PRVC/VC+) use on delivered tidal volumes in patients with acute respiratory distress syndrome (ARDS) or at risk for ARDS.

Materials and methods: Retrospective study of mechanically ventilated adult patients with severe sepsis or septic shock.

Results: A total of 272 patients were divided into patients with recognized ARDS, patients without ARDS, and patients with unrecognized ARDS. Over 90% of patients were ventilated with PRVC on admission, resulting in delivered tidal volumes significantly higher than set tidal volumes among all groups at all time points, even after ARDS recognition (p < 0.001). Tidal volumes were lower for patients with pulmonary sepsis as compared to those with a nonpulmonary origin (p < 0.001).

Conclusions: Using PRVC promotes augmented delivered tidal volumes, often in excess of 6 mL/kg ideal body weight. Correct recognition of ARDS and having pulmonary sepsis improves compliance with low-stretch protocol ventilation.

Keywords: Acute respiratory distress syndrome; adult; artificial; critical care; respiration; sepsis; septic; shock; ventilator-induced lung injury.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Sources of sepsis origin.
Figure 1.
Figure 1.
Sources of sepsis origin.
Figure 2.
Figure 2.
Ventilation modes used among all groups.
Figure 2.
Figure 2.
Ventilation modes used among all groups.
See this image and copyright information in PMC

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