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The effect of changing from pressure support ventilation to volume control ventilation on renal function
J Botha1, P Mudholkar, V Le Blanc
1Intensive Care Unit, Frankston Hospital, Frankston, Victoria.
Summary
Volume controlled (VC) ventilation showed no adverse effects on renal function compared to pressure support ventilation (PSV). Key renal indices like creatinine clearance, urine volume, and fractional excretion of sodium remained similar between the two ventilation modes.
Area of Science:
- Critical Care Medicine
- Nephrology
- Pulmonary Medicine
Background:
- Mechanical ventilation impacts intrathoracic pressure, cardiac output, and hormonal balance, potentially affecting renal function.
- Understanding the renal effects of different ventilation modes is crucial for optimizing patient care in intensive settings.
Purpose of the Study:
- To compare creatinine clearance, urine volume, and fractional excretion of sodium (FE(Na)) between volume controlled (VC) ventilation and pressure support ventilation (PSV).
Main Methods:
- A within-subjects, non-randomized controlled study was conducted in a mixed medical-surgical ICU.
- Eight mechanically ventilated patients were switched between VC and PSV modes for four-hour periods, with renal function monitored throughout.
- Urine and serum samples were analyzed for urine volume, FE(Na), and creatinine clearance.
Main Results:
- No statistically significant differences were observed in creatinine clearance (p = 0.54), fractional excretion of sodium (p = 0.58), or urine volume (p = 0.42) between VC and PSV.
- Friedman's test was used for statistical analysis.
Conclusions:
- Volume controlled ventilation does not adversely affect renal indices compared to spontaneous pressure support ventilation.
- The findings suggest that VC ventilation is a safe alternative in terms of renal function when compared to PSV.
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