Pressure-regulated volume control mode versus synchronized intermittent mandatory ventilation mode in management of acute respiratory failure complicating advanced liver disease

Abstract

Background A common cause of death in the ICUs is advanced liver disease and its complications. Respiratory complications are common in patients with advanced liver disease. Management of patients with advanced hepatic disease having acute respiratory failure mandates the use of lung-protective ventilation strategies to achieve adequate oxygenation. Objectives The aim of this study was to compare and evaluate the superiority of either pressure-regulated volume control (PRVC) mode versus synchronized intermittent mandatory ventilation (SIMV) mode in management of acute respiratory failure complicating advanced hepatic disease. Patients and methods A total of 80 patients were included in this study, who were randomized into two equal groups of 40 patients each, namely. group S and group PV. Group S was ventilated using SIMV mode, whereas group PV was ventilated using PRVC mode. Results There was a statistically significant difference between group PV and group S during the mechanical ventilation period regarding the PO2/FiO2 ratio, static compliance, and dynamic compliance values, with higher values in group PV than group S providing better oxygenation. There was a statistically significant difference in the duration of mechanical ventilation and the ICU stay between the two groups, with significantly lower values in the PV group than the S group. Conclusion We concluded that PRVC mode of mechanical ventilation is superior to SIMV in acute respiratory failure complicating advanced liver disease, as it resulted in improved oxygenation at lower inflation pressures.