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Pressure-regulated volume control vs volume control ventilation in infants after surgery for congenital heart disease

K C Kocis1, M K Dekeon, H K Rosen

  • 1Department of Pediatrics and Surgery, University of Southern California School of Medicine, Los Angeles, CA 90027, USA.

Pediatric Cardiology
|May 9, 2001
PubMed

Insights

Pressure-regulated volume control (PRVC) ventilation in infants with congenital heart disease reduced peak inspiratory pressure by 19% without impacting hemodynamics, oxygenation, or carbon dioxide removal post-surgery.

Area of Science:

  • Pediatric Critical Care Medicine
  • Cardiothoracic Surgery
  • Mechanical Ventilation

Background:

  • Infants with congenital heart disease (CHD) require mechanical ventilation post-surgery.
  • Optimizing ventilator settings is crucial for hemodynamic stability and gas exchange in this population.

Purpose of the Study:

  • To compare the effects of two positive pressure ventilation modes on cardiac output, airway pressures, oxygenation, and CO2 removal in infants with CHD.
  • To evaluate pressure-regulated volume control (PRVC) against volume control ventilation (VCV) in the immediate postoperative period.

Main Methods:

  • A pretest-post-test study design was used with 9 infants post-CHD repair.
  • Infants were ventilated in volume control mode (VCV1), then pressure-regulated volume control (PRVC), and finally returned to volume control (VCV2).
  • Measurements included hemodynamic parameters, airway pressures, ventilator settings, and arterial blood gases.

Main Results:

  • Pressure-regulated volume control (PRVC) resulted in a 19% decrease in peak inspiratory pressure compared to VCV.
  • No significant differences were observed in cardiac output, oxygenation, or carbon dioxide removal between the ventilation modes.
  • Hemodynamic parameters remained stable throughout the study period.

Conclusions:

  • Mechanical ventilation with a decelerating flow wave pattern (PRVC) is effective in reducing peak inspiratory pressures in infants with CHD post-surgery.
  • PRVC can be safely used without compromising hemodynamic stability or gas exchange in this vulnerable patient group.

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