Long-term volume-targeted pressure-controlled ventilation: sense or nonsense?

Area of Science:

• Respiratory Medicine
• Biomedical Engineering
• Critical Care

Background:

• Noninvasive ventilation technology for chronic hypercapnia is advancing.
• Volume-targeted pressure-controlled ventilation (VTPCV) is a hybrid mode aiming to integrate benefits of existing modes while mitigating drawbacks.
• Varied terminology and patented algorithms by manufacturers cause confusion among clinicians.

Purpose of the Study:

• To review the rationale, principles, and setup of VTPCV.
• To summarize existing clinical and laboratory evidence on VTPCV.
• To address factors hindering the widespread adoption of VTPCV.

Main Methods:

• Literature review of VTPCV technology.
• Analysis of studies evaluating VTPCV performance.
• Synthesis of clinical and laboratory data.

Main Results:

• VTPCV presents a novel approach to mechanical ventilation.
• Lack of standardized terminology and clear evidence of superiority impede clinical uptake.
• Existing studies provide mixed results regarding VTPCV efficacy.

Conclusions:

• VTPCV technology is evolving, offering potential advantages for patients with chronic hypercapnia.
• Standardization and further robust clinical trials are necessary to establish VTPCV's role in respiratory care.
• Addressing clinician confusion and demonstrating clear benefits are crucial for wider implementation.