Abstract:

Objective: Mechanical ventilation is a life-saving practice in acute respiratory distress syndrome (ARDS) patients. However, if not used properly, it causes ventilator-induced lung injury (VILI). Therefore, mechanical power (MP), which combines different variables associated with VILI in a single parameter and is affects mortality, is important in the management of patients with ARDS. In this study, MP values calculated over pressurevolume loops of volume control (VCV) and pressure regulated volume control (PRVC) modes were compared. Methods: While 36 patients received controlled mechanical ventilation support (VCV and PRVC) under deep sedation, in the supine position on the second day of their intensive care unit hospitalization, MP values were calculated from minute respiratory mechanics. After calculating the 60-minute MP of the patients in the VCV mode with the (MPvcv) (simpl) formula, they were switched to the PRVC mode and the 60-minute MP values were calculated with the MPprvc (simpl) formula. The opposite was done for patients initially ventilated in the PRVC mode. In this way, two dependent groups were formed. All data of 36 patients registered in the ‘Metasivionback server’ were transferred to Excel with Structured Query Language, and then the patient averages were obtained and compared with the paired t-test. Results: MP (p<0.0001), work of breathing ventilatory (p<0.0001) mean values were found to be statistically significantly higher in the PRVC group than in the VCV group. Peak airway pressure (p<0.0001) mean values in the VCV group were found to be statistically significantly higher than those in the PRVC group. No significant difference was found between other respiratory parameters. Conclusion: Although the respiratory parameters (tidal volume, drive pressure and respiratory rate) that contribute to the calculation of MP are similar, lower power values are calculated in VCV mode compared to PRVC.

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