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Flow-controlled Ventilation Improves Gas Exchange in Lung-healthy Patients – a Randomised Interventional Cross-over Study

Jonas WeberJohannes SchmidtLeonie StrakaSteffen WirthStefan Schumann

出版	Universität, 2020
URL	http://books.google.com.hk/books?id=u8uozQEACAAJ&hl=&source=gbs_api

註釋Abstract: Background
Flow-controlled ventilation (FCV) is a new ventilation mode that provides constant inspiratory and expiratory flow. FCV was shown to improve gas exchange and lung recruitment in porcine models of healthy and injured ventilated lungs. The primary aim of our study was to verify the influences of FCV on gas exchange, respiratory mechanics and haemodynamic variables in mechanically ventilated lung-healthy patients.

Methods
After obtaining ethical approval and informed consent, we measured arterial blood gases, respiratory and haemodynamic variables during volume-controlled ventilation (VCV) and FCV in 20 consecutive patients before they underwent abdominal surgery. After baseline (BL) ventilation, patients were randomly assigned to either BL-VCV-FCV or BL-FCV-VCV. Thereby, BL ventilation settings were kept, except for the ventilation mode-related differences (FCV is supposed to be used with an I:E ratio of 1:1).

Results
Compared to BL and VCV, PaO2 was higher [PaO2: FCV: 38.2 (7.1), BL ventilation: 35.0 (5.8), VCV: 35.2 (7.0) kPa, P .001] and PaCO2 lower [PaCO2: FCV: 4.8 (0.5), BL ventilation: 5.1 (0.5), VCV: 5.1 (0.5) kPa, P .001] during FCV. With comparable plateau pressure [BL: 14.9 (1.9), VCV: 15.3 (1.6), FCV: 15.2 (1.5) cm H2O), P = .185], tracheal mean pressure was higher during FCV [BL: 10.2 (1.1), VCV: 10.4 (0.7), FCV: 11.5 (1.0) cm H2O, P .001]. Haemodynamic variables did not differ between ventilation phases.