Comparing the Effect of Volume-controlled Ventilation and Synchronized Intermittent Mandatory Ventilation on Respiratory Parameters of Traumatic Brain Injury Patients
DOI:
https://doi.org/10.70749/ijbr.v3i4.1078Keywords:
Volume-Controlled Ventilation, Synchronized Intermittent Mandatory Ventilation, Traumatic Brain Injury, Respiratory ParametersAbstract
Introduction: Traumatic brain injury (TBI) often necessitates mechanical ventilation to support respiratory function. This study compares the outcomes of volume-controlled ventilation (VCV) and synchronized intermittent mandatory ventilation (SIMV) in TBI patients, focusing on respiratory and neurological outcomes. Materials and Methods: This study was conducted at Lady Reading Hospital in Peshawar, Pakistan from March 2024 to September 2024. A total of 100 TBI patients (50 VCV, 50 SIMV) were enrolled. Demographic data, including age, gender, BMI, smoking status, and comorbidities, were collected. Respiratory parameters (respiratory rate, tidal volume, PaO₂, PaCO₂, pH, SpO₂) were recorded at baseline and after 48 hours. Neurological outcomes were assessed using the Glasgow Coma Scale (GCS) at day 7. Statistical comparisons were made using t-tests and chi-square tests. Results: Demographic and clinical characteristics were similar between the VCV and SIMV groups. Baseline respiratory parameters showed no significant differences. After 48 hours, the VCV group had a lower respiratory rate (18.3 vs. 19.5 breaths/min, p = 0.03), higher PaO₂ (90.2 vs. 85.6 mmHg, p = 0.02), and more effective carbon dioxide elimination (PaCO₂ 37.0 vs. 39.1 mmHg, p = 0.01). Complications, such as ventilator-associated pneumonia, barotrauma, and oxygen toxicity, were comparable between groups. Neurological outcomes showed a trend toward improvement in the VCV group (48% vs. 34%, p = 0.14). Conclusion: VCV provided better respiratory outcomes than SIMV, with improved oxygenation and more efficient carbon dioxide elimination. Though both ventilation strategies had similar complication rates, VCV may offer a slight advantage in neurological recovery. Further research is needed to confirm these findings.
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Celli, P., Privato, E., Ianni, S., Babetto, C., D’Arena, C., Guglielmo, N., Maldarelli, F., Paglialunga, G., Rossi, M., Berloco, P., Ruberto, F., & Pugliese, F. (2014). Adaptive support ventilation versus synchronized intermittent mandatory ventilation with pressure support in weaning patients after Orthotopic liver transplantation. Transplantation Proceedings, 46(7), 2272-2278. https://doi.org/10.1016/j.transproceed.2014.06.046
Singer, B. D., & Corbridge, T. C. (2011). Pressure modes of invasive mechanical ventilation. Southern Medical Journal, 104(10), 701-709. https://doi.org/10.1097/smj.0b013e31822da7fa
Mireles-Cabodevila, E., Diaz-Guzman, E., Heresi, G. A., & Chatburn, R. L. (2009). Alternative modes of mechanical ventilation: A review for the hospitalist. Cleveland Clinic Journal of Medicine, 76(7), 417-430. https://doi.org/10.3949/ccjm.76a.08043
Alikiaii, B., Aghadavoudi, O., & Sadeghi, F. (2016). Comparison of respiratory and hemodynamic stability in patients with traumatic brain injury ventilated by two ventilator modes: Pressure regulated volume control versus synchronized intermittent mechanical ventilation. Advanced Biomedical Research, 5(1), 175. https://doi.org/10.4103/2277-9175.190991
Schirmer-Mikalsen, K., Vik, A., Skogvoll, E., Moen, K. G., Solheim, O., & Klepstad, P. (2015). Intracranial pressure during pressure control and pressure-regulated volume control ventilation in patients with traumatic brain injury: A randomized crossover trial. Neurocritical Care, 24(3), 332-341. https://doi.org/10.1007/s12028-015-0208-8
Zhu, F., Gomersall, C. D., Ng, S. K., Underwood, M. J., & Lee, A. (2015). A randomized controlled trial of adaptive support ventilation mode to wean patients after fast-track cardiac valvular surgery. Anesthesiology, 122(4), 832-840. https://doi.org/10.1097/aln.0000000000000589
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