Comparison and evaluation between pressure-regulated volume control ventilation and synchronized intermittent mandatory evaluation in acute exacerbations of chronic obstructive pulmonary disease

Background and aim Pressure-regulated volume-controlled ventilation (PRVC) is a type of dual-control ventilation that offers the benefits of either volume-controlled ventilation and pressure-controlled ventilation. This study aimed to evaluate the efficacy of PRVC and synchronized intermittent mandatory ventilation (SIMV) in the management of patients with chronic obstructive pulmonary disease (COPD) having acute exacerbations necessitating mechanical ventilation. Patients and methods This prospective clinical trial study was carried out on 60 COPD patients, divided into the SIMV group, which included patients ventilated by the SIMV mode, and the PRVC group, which included patients ventilated by the PRVC mode. All patients were subjected to clinical assessment, and laboratory investigations included complete blood count, random blood glucose, liver and kidney function tests, arterial blood gases, plain chest radiograph, ECG, and echocardiography. The outcome was determined. Results The PaCO 2 , PIP, and RR were lower, and the exhaled MV was higher in the PRVC mode than in SIMV mode 24 h after ventilation. The mortality rate was lower in PRVC than in SIMV mode, with no significant difference. Conclusion PRVC is a recent alternative mode of ventilation in acute exacerbation of COPD patients. It improves some arterial blood gas parameters in mechanically ventilated patients and seems to be better than SIMV ventilation in terms of safety and efficacy.