Impact of pressure-targeted modes of ventilation on diaphragmatic function as assessed using ultrasonography in critically ill patients with cerebral insult: a randomized clinical trial
Mosadek, H., Kamel, A., El-Owaidy, R., Kamal, M., Maarouf, M. (2023). Impact of pressure-targeted modes of ventilation on diaphragmatic function as assessed using ultrasonography in critically ill patients with cerebral insult: a randomized clinical trial. EKB Journal Management System, 15(1), -. doi: 10.1186/s42077-023-00340-8
Hadeer Mosadek; Amr Mohamed EL.-Said Kamel; Raham Hassan Mostafa El-Owaidy; Mohamed Mohamed Kamal; Mohammed Mahmoud Maarouf. "Impact of pressure-targeted modes of ventilation on diaphragmatic function as assessed using ultrasonography in critically ill patients with cerebral insult: a randomized clinical trial". EKB Journal Management System, 15, 1, 2023, -. doi: 10.1186/s42077-023-00340-8
Mosadek, H., Kamel, A., El-Owaidy, R., Kamal, M., Maarouf, M. (2023). 'Impact of pressure-targeted modes of ventilation on diaphragmatic function as assessed using ultrasonography in critically ill patients with cerebral insult: a randomized clinical trial', EKB Journal Management System, 15(1), pp. -. doi: 10.1186/s42077-023-00340-8
Mosadek, H., Kamel, A., El-Owaidy, R., Kamal, M., Maarouf, M. Impact of pressure-targeted modes of ventilation on diaphragmatic function as assessed using ultrasonography in critically ill patients with cerebral insult: a randomized clinical trial. EKB Journal Management System, 2023; 15(1): -. doi: 10.1186/s42077-023-00340-8

Impact of pressure-targeted modes of ventilation on diaphragmatic function as assessed using ultrasonography in critically ill patients with cerebral insult: a randomized clinical trial

Ain-Shams Journal of Anesthesiology
Volume 15, Issue 1, January 2023  XML PDF (1.39 MB)
DOI: 10.1186/s42077-023-00340-8
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Authors
Hadeer Mosadek email orcid ; Amr Mohamed EL.-Said Kamel; Raham Hassan Mostafa El-Owaidyorcid ; Mohamed Mohamed Kamal; Mohammed Mahmoud Maarouf
Abstract
Background
Mechanical ventilation causes diaphragmatic atrophy and reduces diaphragmatic efficiency. Patients with diaphragmatic dysfunction have longer mechanical ventilation durations and intensive care unit stay. There is currently a scarcity of data on the effect of different modes of mechanical ventilation on diaphragmatic function and ultrasound-guided assessment of diaphragmatic efficiency.
Results
Sixty mechanically ventilated patients were randomly divided into four equal groups (15 each): patients were ventilated using either assist control pressure-controlled mode (group A), synchronized intermittent mandatory ventilation pressure-controlled mode (group S), bi-level-positive airway pressure mode (group B) or pressure support ventilation mode (group P). The primary outcome was to assess the diaphragmatic excursion, while the secondary outcomes were to assess the diaphragmatic thickness fraction and the duration of the ICU stay. Patients in the P group had the highest diaphragmatic excursion indicating better diaphragmatic function.
Conclusions
When compared to other pressure-targeted ventilation modes, the pressure support ventilation mode may have the least risk of diaphragmatic dysfunction as preserves diaphragmatic structure and strength.
Trial registration
The clinical trial was retrospectively registered at PACTR202112653971335.
Keywords
Diaphragmatic; dysfunction; Ventilation; Cerebral; excursion; thickness
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