Published online Sep 16, 2023. doi: 10.12998/wjcc.v11.i26.6040
Peer-review started: June 30, 2023
First decision: July 18, 2023
Revised: July 19, 2023
Accepted: August 18, 2023
Article in press: August 18, 2023
Published online: September 16, 2023
Processing time: 70 Days and 0.3 Hours
When Respiratory failure occurs in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD), the most effective ventilation method is still unclear. This study analyzed the effects and side effects of different ventilation techniques on the deterioration of acute COPD. Mechanical ventilation is a life-saving measure for patients with exacerbation of acute COPD and Respiratory failure, but it may also lead to adverse reactions. This study compared the efficacy and safety of volume control ventilation (VCV) and pressure control ventilation (PCV) in patients with exacerbation of acute COPD and Respiratory failure. The results showed that PCV can reduce peak airway pressure (PAP) and the incidence of barotrauma, which may be a safer ventilation mode.
At present, there is limited understanding of the most effective ventilation methods for treating patients with acute exacerbation of COPD. The purpose of this study was to compare the efficacy and safety of VCV and PCV in patients with exacerbation of acute COPD and Respiratory failure. We studied 600 hospitalized patients with severe exacerbation of COPD, of whom 400 received mechanical ventilation. The results showed that the PCV group performed better in terms of PAP and the incidence of barotrauma compared to the VCV group.
The primary objective of this study is to compare the efficacy and safety of VCV and PCV in patients experiencing an acute exacerbation of COPD and respiratory failure. We aim to determine whether PCV can lower PAPs and reduce the incidence of barotrauma compared to VCV, without compromising clinical outcomes and oxygenation parameters. Additionally, we seek to explore the factors influencing the choice of ventilation mode and the prognosis of these patients, including lung mechanics, gas exchange, hemodynamics, and complications.
This study evaluated 600 hospitalized patients with severe COPD exacerbation, of which 400 required mechanical ventilation for respiratory failure. The participants were divided into two groups, receiving either VCV or PCV with appropriate management. Patient characteristics, clinical factors, and laboratory, radiographic, and arterial blood gas evaluations were observed at the start and during their intensive care unit (ICU) stay. Statistical methods were employed for data analysis. Both VCV and PCV groups showed significant improvements in respiratory rate, tidal volume, and arterial blood gas values during ICU stay. No significant differences were found between the groups in terms of oxygenation indices and partial pressures of carbon dioxide (PaCO2) improvements. PCV demonstrated lower PAPs throughout mechanical ventilation and a significantly lower incidence of barotrauma compared to VCV.
Both VCV and PCV were effective in treating patients with acute exacerbation of COPD. Significant improvements were observed in respiratory rate, tidal volume, and arterial blood gas values for both groups during ICU stay. There were no significant differences between VCV and PCV in terms of oxygenation indices and PaCO2 improvements. Hospital mortality, duration of ICU stay, and duration of mechanical ventilation did not show significant differences between the two groups. However, the PCV group exhibited lower PAPs throughout mechanical ventilation and a significantly lower incidence of barotrauma compared to the VCV group. These findings suggest that PCV may be a safer ventilation method for patients with acute COPD exacerbation.
This study compared VCV and PCV in patients with acute exacerbation of COPD and respiratory failure. Both VCV and PCV were found to be effective in improving respiratory parameters and arterial blood gas values during ICU stay. However, PCV demonstrated advantages over VCV, with lower PAPs and a significantly reduced incidence of barotrauma. There were no significant differences between the two groups in terms of oxygenation indices, hospital mortality, duration of ICU stay, or duration of mechanical ventilation. These findings suggest that PCV may be a safer ventilation method for patients with acute COPD exacerbation.
This study highlights the need for a better understanding of effective ventilation methods for acute COPD exacerbation and respiratory failure. The comparison between VCV and PCV provides insights into their efficacy and safety, with PCV showing advantages such as lower PAPs and reduced barotrauma incidence. However, further large-scale studies are required to validate these findings and determine the optimal ventilation approach. Future research should focus on identifying factors that influence ventilation mode selection and patient prognosis, including lung mechanics, gas exchange, hemodynamics, and complications. Additionally, personalized ventilation strategies tailored to individual characteristics and needs should be explored to enhance patient outcomes. These efforts aim to improve the survival and quality of life for individuals experiencing acute COPD exacerbation.