Mechanical Power Differs Between Pressure-Controlled Ventilation and Different Volume-Controlled Ventilation Modes

Critical Care Explorations, vol. 4, pp. e0741

Abstract

OBJECTIVES: Mechanical power (MP) is a way of estimating the energy delivered by the ventilator to the patient. For both volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) methods have been described to calculate the MP. The pressure-volume (PV) loop, from which the MP is calculated, is different for VCV compared with PCV. We aimed to compare the MP of VCV with zero pause time (VCV-0), VCV with 10% pause time (VCV-10), and PCV within patients in different patient categories based on severity of lung injury. DESIGN: In a proof-of-concept study, we enrolled 46 mechanically ventilated patients without spontaneous breathing efforts. Baseline measurements were done in pressure-controlled mode. Subsequently, measurements were done in VCV-0 and VCV-10. Tidal volume and all other settings were kept the same. SETTING: ICU, single university medical center. PATIENTS: Fifty-eight cases in 46 patients on controlled ventilation modes. INTERVENTIONS: Comparison between the MP of PCV, VCV-0, and VCV-10. MEASUREMENT AND MAIN RESULTS: < 0.05 for all comparisons). CONCLUSIONS: In patients ventilated in a controlled mode, VCV without pause time had the lowest MP followed by PCV. VCV with 10% pause time had the highest MP.

Authors 7

1. Petra J. Rietveld Aachen All authors: Department of Intensive Care

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   All authors: Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccejournal)

2. Jacob W. M. Snoep Aachen All authors: Department of Intensive Care

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   All authors: Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccejournal)

3. Marjolein Lamping Aachen All authors: Department of Intensive Care

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   All authors: Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccejournal)

4. Franciska van der Velde Aachen All authors: Department of Intensive Care

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   All authors: Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccejournal)

5. Evert de Jonge Aachen All authors: Department of Intensive Care

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   All authors: Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccejournal)

6. David J. van Westerloo Aachen All authors: Department of Intensive Care

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   All authors: Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccejournal)

7. Abraham Schoe Aachen All authors: Department of Intensive Care

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   All authors: Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccejournal)