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Time-Controlled Adaptive Ventilation Does Not Induce Hemodynamic Impairment in a Swine ARDS Model
Mickael Lescroart1,2,3, Benjamin Pequignot1,2,3, Laurent Bitker4,5
1CHRU Nancy, Service de Médecine Intensive et Réanimation, Hôpital Brabois, Vandœuvre-lès-Nancy, France.
Frontiers in Medicine
|June 3, 2022
Summary
Time-controlled adaptive ventilation (TCAV) shows promise for acute respiratory distress syndrome (ARDS) patients. This ventilation strategy improved lung mechanics without adverse hemodynamic effects in a porcine model.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
- Mechanical Ventilation
Background:
- Severe acute respiratory distress syndrome (ARDS) management typically uses low tidal volume (VT) ventilation.
- Time-controlled adaptive ventilation (TCAV) is an alternative strategy using airway pressure release ventilation (APRV) settings.
- TCAV aims to reduce lung injury by improving alveolar recruitment and reducing micro-strain.
Purpose of the Study:
- To compare hemodynamic effects between TCAV and conventional protective ventilation in a porcine ARDS model.
- To evaluate the efficacy of TCAV in managing severe ARDS.
Main Methods:
- ARDS was induced in 10 pigs via saline lavage and injurious ventilation.
- Animals were randomized to conventional protective ventilation (VT 6 mL/kg) or TCAV.
- Hemodynamic parameters and respiratory mechanics were monitored.
Main Results:
- Both ventilation strategies maintained severe ARDS indicators.
- No significant differences in systemic or pulmonary blood pressure, or cardiac output were observed.
- TCAV resulted in significantly higher total PEEP and lower driving pressure and lung elastance.
Conclusions:
- TCAV did not cause adverse hemodynamic events compared to conventional ventilation in this ARDS model.
- TCAV demonstrated potential benefits for the respiratory system in ARDS.
- Further investigation into TCAV for ARDS management is warranted.
