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Non-Conventional Modes
To determine whether the mode of ventilation alters lung strain, Edibam and coworkers
studied 18 patients with acute lung injury. Thirty minutes of ventilation with three modes—volume-control, pressure-control, and pressure-controlled inverse-ratio—had equivalent effects on static mechanics, oxygenation, and hemodynamics. Nonlinear behavior, as a fraction of total elastance, was higher with pressure-control (36%) than with volume-control (25%) and lowest with pressure-controlled inverse-ratio (16%). Computed tomography revealed about 25% more overinflated units in the left subcarinal region with pressure-controlled inverse-ratio ventilation than with either of the two other modes. The authors conclude that lung strain in patients with acute lung injury is greater with pressure-controlled inverse-ratio ventilation than with volume-control ventilation, and least with pressure-control ventilation.
In a critical care perspective, Bollen and colleagues
present a meta-analysis on use of high-frequency and conventional ventilation.
Citations 1-2 of 2 total displayed.
Cumulative Metaanalysis of High-frequency Versus Conventional Ventilation in Premature Neonates
- Casper W. Bollen, Cuno S. P. M. Uiterwaal, and Adrianus J. van Vught
Am. J. Respir. Crit. Care Med. 168: 1150-1155.
[Full text]
Effect of Inspiratory Flow Pattern and Inspiratory to Expiratory Ratio on Nonlinear Elastic Behavior in Patients with Acute Lung Injury
- Cyrus Edibam, Albert J. Rutten, Daniel V. Collins, and Andrew D. Bersten
Am. J. Respir. Crit. Care Med. 167: 702-707.
[Abstract]
[Full text]
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