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Updated: Aug 4, 2026
Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
Published on: November 26, 2018
Haemodynamic effects of pressure-controlled ventilation versus volume-controlled ventilation in patients submitted to
J O Auler Júnior1, M J Carmona, M H Silva
1Anesthesia and Critical Care Department, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.
Objective:
To compare the haemodynamic effects of pressure-controlled ventilation (PCV) with volume-controlled ventilation (VCV) in patients after cardiac surgery.
Design:
Prospective clinical study.
Setting:
Post-operative cardiac surgical ICU.
Subjects:
Twenty sequential elective adult patients with no previous chronic lung disease and aged less than 70 years old.
Interventions:
One hour after ICU admission and receiving mechanical ventilation utilising sinusoidal flow, patients were divided into two groups according to cardiac index (CI): group I: CI > 2.5 l/min/M2 and group II: CI < 2.5 l/min/M2. They were submitted randomly to 15 minutes' PC or VC mode, a 30-minute wash-out period of mechanical ventilation with a sinusoidal flow pattern, and then alternate PC or VC mode for 15 more minutes. Data were statistically compared using analysis of variance (ANOVA) with a significance level of 5%. Sedatives and muscle relaxants were given as necessary.
Endpoints:
Data were obtained at the end of 15 minutes under each ventilatory mode, observing a 30-minute interval between each.
Measurements:
Standard cardiorespiratory parameters were measured or calculated using conventional monitoring (including cardiac output), Qs/Qt, A-aDO2 alveolar-arterial oxygen difference, peak inspiratory pressure, mean airway pressure and dynamic compliance (C).
Results:
No significant differences between PCV and VCV modes, or between groups, were seen in MPAP, MAP, PCWP, RAP, heart rate, O2ER, VO2I, Paw, C, A-aDO2 and Qs/Qt. However, DO2I (p = 0.0063), LVSWI, (p = 0.0001) and RVSWI (p = 0.0053) showed a statistically significant difference between groups I and II. No influence of VCV or PCV on these parameters was seen. There was a slight significant difference between groups for PVR (p = 0.0205). In contrast, CI (p = 0.0001) and SVR (p = 0.0062) showed significant differences among groups, but also a significantly favourable effect of PCV over VCV (p = 0.0239 and p = 0.0318 respectively). Finally, a significant reduction (p = 0.0001) in peak inspiratory pressure with PCV was observed.
Conclusion:
PC and VC ventilatory modes had comparable effects on patients with preserved or depressed cardiac output. Patients ventilated with PCV showed significantly higher values for cardiac index, a decreased SVR, as well as significantly lower values for inspiratory pressure when compared with VCV patients.
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