Lung-protective strategy of acute respiratory distress syndrome
El-Moety, M., Ahmed, K., Osman, A., El-Qader, R. (2023). Lung-protective strategy of acute respiratory distress syndrome. EKB Journal Management System, 8(2), 79-85. doi: 10.4103/JCMRP.JCMRP_35_20
Marwa A.A. El-Moety; Khaled H. Ahmed; Ahmed H. Osman; Randa E.E.-D.A. El-Qader. "Lung-protective strategy of acute respiratory distress syndrome". EKB Journal Management System, 8, 2, 2023, 79-85. doi: 10.4103/JCMRP.JCMRP_35_20
El-Moety, M., Ahmed, K., Osman, A., El-Qader, R. (2023). 'Lung-protective strategy of acute respiratory distress syndrome', EKB Journal Management System, 8(2), pp. 79-85. doi: 10.4103/JCMRP.JCMRP_35_20
El-Moety, M., Ahmed, K., Osman, A., El-Qader, R. Lung-protective strategy of acute respiratory distress syndrome. EKB Journal Management System, 2023; 8(2): 79-85. doi: 10.4103/JCMRP.JCMRP_35_20

Lung-protective strategy of acute respiratory distress syndrome

Journal of Current Medical Research and Practice
Volume 8, Issue 2, April 2023, Page 79-85  XML PDF (887.5 K)
DOI: 10.4103/JCMRP.JCMRP_35_20
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Authors
Marwa A.A. El-Moety; Khaled H. Ahmed; Ahmed H. Osman; Randa E.E.-D.A. El-Qader
Abstract
Introduction
Acute respiratory distress syndrome (ARDS) constitutes a major phenotype of acute hypoxemic respiratory failure. Pressure control (PC) and volume control (VC) modes are used for the management of moderate and severe ARDS. Each mode has its benefits and drawbacks.
Aim
The aim of this study was to compare lung-protective strategy (LPS) using PC ventilation with LPS using VC ventilation to get the best benefit for those critically ill ARDS patients and to solve the problem of hypoventilation.
Patients and methods
This prospective, randomized controlled trial was carried out at the respiratory intensive care unit of university hospital during the period from October 2017 to December 2018. The study included 30 patients diagnosed as ARDS according to Berlin definition. Those patients were categorized into two groups: group I is the PC group (15 patients) using the LPS and group II is the VC group (15 patients) using the LPS.
Results
The mean age was 48.93 ± 9.91 years for the PC group with female predominance (53.3%), while the mean age was 46.11 ± 7.94 for the VC group with male predominance (53.3%). Arterial blood gases showed a significant higher pH and lower PaCO in the VC group. Mechanical parameters showed a significant higher V and V in the VC group. Weaning and outcome in both groups were successful, while seven of the patients of PC (46.7%) and four of the patients of VC (26.7%) failed extubation and died.
Conclusion
The authors conclude that both modes are equally effective in improving oxygenation in patients of ARDS, who were ventilated with LPS, while VC achieved better ventilation, higher pH, and lower PCO than PC. But it needs strict monitoring of plateau pressure to maintain safety.
Keywords
acute respiratory distress syndrome; lung-protective strategy; Mechanical Ventilation; strategies
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