Pressure support mode versus volume support mode for weaning mechanically ventilated patients

Background Mechanical ventilation is vital for managing respiratory failure, but long-term use can lead to complications. Weaning may be difficult due to muscle weakness, impaired drive, and patient–ventilator asynchrony. Timely weaning helps reduce morbidity and ICU stay. Aim This study aimed to evaluate and compare the effectiveness of pressure support (PS) and volume support (VS) modes regarding weaning success. The primary endpoint was the weaning success rate. At the same time, additional endpoints included weaning duration, reintubation rates, ICU stay length, and variations in clinical parameters, lung mechanics, and vital signs. Patients and methods This prospective, randomized, controlled study included 102 adult ICU patients at Menoufia University Hospitals. Patients eligible for simple weaning were randomized to either the PS or VS groups. Clinical and ventilatory data were collected and analyzed. Results Successful weaning occurred in 74.5% of PS and 78.4% of VS patients ( P =0.641). Postextubation noninvasive ventilation (NIV) was needed in 23.5% of PS and 19.6% of VS patients ( P =0.630). Sedation was required in 17.6% (PS) and 15.7% (VS) ( P =0.790). Median weaning duration was slightly shorter in the VS group (2 h, interquartile range: 2–5) compared with the PS group (3 h, interquartile range: 2–6), as was the duration of postextubation NIV (3.0 vs. 4.0 days), though neither difference was statistically significant. Initial spontaneous breathing trial failure occurred in 9.8% (PS) and 5.9% (VS) ( P =0.715). Conclusion VS ventilation showed a trend toward better weaning performance, including shorter weaning time and reduced need for sedation and NIV. However, invasive mechanical ventilation duration and ICU stay were slightly shorter with PS ventilation. Further research with larger sample sizes is necessary to validate these results.