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. 2022 Aug 15;4(8):e0741.
doi: 10.1097/CCE.0000000000000741. eCollection 2022 Aug.

Mechanical Power Differs Between Pressure-Controlled Ventilation and Different Volume-Controlled Ventilation Modes

Petra J Rietveld  1 , Jacob W M Snoep  1 , Marjolein Lamping  1 , Franciska van der Velde  1 , Evert de Jonge  1 , David W van Westerloo  1 , Abraham Schoe  1
Affiliations

Mechanical Power Differs Between Pressure-Controlled Ventilation and Different Volume-Controlled Ventilation Modes

Petra J Rietveld et al. Crit Care Explor. .

Abstract

Objectives: Mechanical power (MP) is a way of estimating the energy delivered by the ventilator to the patient. For both volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) methods have been described to calculate the MP. The pressure-volume (PV) loop, from which the MP is calculated, is different for VCV compared with PCV. We aimed to compare the MP of VCV with zero pause time (VCV-0), VCV with 10% pause time (VCV-10), and PCV within patients in different patient categories based on severity of lung injury.

Design: In a proof-of-concept study, we enrolled 46 mechanically ventilated patients without spontaneous breathing efforts. Baseline measurements were done in pressure-controlled mode. Subsequently, measurements were done in VCV-0 and VCV-10. Tidal volume and all other settings were kept the same.

Setting: ICU, single university medical center.

Patients: Fifty-eight cases in 46 patients on controlled ventilation modes.

Interventions: Comparison between the MP of PCV, VCV-0, and VCV-10.

Measurement and main results: The mean MP of VCV-0, VCV-10, and PCV was 19.30, 21.80, and 20.87 J/min, respectively (p < 0.05 for all comparisons). The transpulmonary MP of VCV-0, VCV-10, and PCV was 6.75, 8.60, and 7.99 J/min, respectively (p < 0.05 for all comparisons).

Conclusions: In patients ventilated in a controlled mode, VCV without pause time had the lowest MP followed by PCV. VCV with 10% pause time had the highest MP.

Keywords: mechanical power; mechanical ventilation; pressure-controlled ventilation; stress and strain of the lung; ventilator-induced lung injury; volume-controlled ventilation.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
The flow of volume-controlled ventilation with 10% pause time (VCV-10) mode is higher than the flow of volume-controlled ventilation with 0 pause time (VCV-0) mode due to the pause time. The pressure-controlled ventilation (PCV) flow curve is completely different in nature. The flow curves are from the same patient.
Figure 2.
Figure 2.
The peak pressure of volume-controlled ventilation with 10% pause time (VCV-10) mode is higher than the peak pressure of volume-controlled ventilation with 0 pause time (VCV-0) mode. Pressurization in pressure-controlled ventilation (PCV) is completely different in nature. The pressure curves are from the same patient.
Figure 3.
Figure 3.
The area between the inspiratory limb of the pressure-volume (PV) loop and the zero-pressure axis is equivalent to the energy of a breath. The PV area of volume-controlled ventilation with 10% pause time (VCV-10) is larger than that of volume-controlled ventilation with 0 pause time (VCV-0). The PV area of the pressure-controlled ventilation (PCV) completely different in nature. The PV loops are from the same patient.
See this image and copyright information in PMC

References

    1. de Prost N, Ricard JD, Saumon G, et al. : Ventilator-induced lung injury: Historical perspectives and clinical implications. Ann Intensive Care 2011; 1:28. - PMC - PubMed
    1. Gattinoni L, Carlesso E, Cadringher P, et al. : Physical and biological triggers of ventilator-induced lung injury and its prevention. Eur Respir J Suppl 2003; 47:15s–25s - PubMed
    1. Tonetti T, Vasques F, Rapetti F, et al. : Driving pressure and mechanical power: New targets for VILI prevention. Ann Transl Med 2017; 5:286. - PMC - PubMed
    1. Gattinoni L, Tonetti T, Cressoni M, et al. : Ventilator-related causes of lung injury: The mechanical power. Intensive Care Med 2016; 42:1567–1575 - PubMed
    1. Cressoni M, Gotti M, Chiurazzi C, et al. : Mechanical power and development of ventilator-induced lung injury. Anesthesiology 2016; 124:1100–1108 - PubMed