Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Back ground: Pressure-regulated volume control (PRVC) mode is a kind of dual-control ventilation that uses tidal volume as a feed back control for continuously adjusting the pressure limit. METHOD: All patients were ventilated using Puritan Bennett 840 ventilators. Patients on PC mode of mechanical ventilation were monitored for 6 hours and then were switched on PRVC mode of mechanical ventilation and monitored for another 6 hours. AIM:The present Short-term crossover study aimed at determine whether volume-targeted ventilation compared with pressure-limited ventilation in patients with acute hypoxemic lung failure leads to decrease in work of breathing, peaked inspiratory pressure with improvement in gas exchange . RESULT: There were significantly decrease in MAP (10.37 ± 1.64) and P.PEAK (22.13±3.04) on PRVC mode compared with MAP (13.23 ± 2.27) and P.PEAK (28.73±3.99) on SIMV mode with p value <0.001in 1st hr and After six hrs there were significantly decrease in MAP(9.64 ± 1.69) and P.PEAK (20.69±2.74) on PRVC mode when compared with MAP (12.33 ± 2.03) and P.PEAK (27.97±3.32) on SIMV mode with p value <0.001and,There were significant improvement of oxygenation .At 1st hr OI (6.34± 2.26),PaO2/PAO2(0.36 ±0.06) on PRVC compared with SIMV OI(11.86± 5.03),PaO2/PAO2(0.25± 0.05) with a p value <0.001., PaO2/FiO2 (210.86±245.57) on PRVC compared with and PaO2/FiO2 (121.83 ±29.46) on SIMV with a P value=0.018. After six hours OI (4.67± 1.64), PaO2/PAO2(0.47±0.10) on PRVC compared with SIMV OI(8.01± 3.26),PaO2/PAO2(0.35± 0.08) with a p value <0.001. CONCLUSION: There were significantly decrease in both MAP and P.PEAKon PRVC mode, there were significant improvement in oxygenation and ventilation on PRVC mode

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