Comparative Study Between the Effect of Airway Pressure Release Ventilation and Synchronized Intermittent Mandatory Ventilation in Acute Respiratory Distress Syndrome

Document Type : Original Article

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Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Abstract

Background: Acute respiratory distress syndrome [ARDS] is a serious illness with a high fatality rate and a bleak prognosis. Mechanical ventilation [MV] is now regarded as one of the best methods for treating ARDS. In order to determine whether the breathing technique was safer and more effective for patients with acute ARDS.
The aim of the work: This study aimed to compare airway pressure release ventilation [APRV] mode and synchronized intermittent mandatory ventilation [SIMV] mode with lung protective strategy protocol.
Patients and Methods: This prospective study included 34 patients aged 20 to 75 years old, both sexes with ARDS. Patients were divided randomly into two equal groups: Group A: APRV mode and group B: SIMV mode with lung protective strategy protocol.
Results: Group A had substantially greater PaO2, PaO2/FiO2 ratio and respiratory compliance at 12, 24, 36, 48, 72 and 96 hours than group B. Group A had considerably lower FiO2 and plateau pressure at 12, 24, 36, 48, 72 and 96 hours than group B. Group A showed significantly shorter total ventilator days and intensive care unit [ICU] stay compared to group B [P<0.05]. Both groups had similar rates of ICU mortality and successful extubation. Both groups had a comparable heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure.
Conclusions: In comparison to SIMV mode with the lung protective strategy protocol, APRV mode has a compatible effect and safer outcomes.

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