Abstract
BACKGROUND: Patients receiving mechanical ventilation commonly experience sleep fragmentation. The present meta-analysis compared the effects of pressure controlled ventilation (PCV) and pressure support ventilation (PSV) on sleep quality.
METHODS: We conducted a search of the PubMed, Embase, and Cochrane Library databases for studies published before November 2023. In this meta-analysis, individual effect sizes were standardized, and the pooled effect size was determined by using random-effects models. The primary outcome was sleep efficiency. The secondary outcomes were wakefulness, percentages of REM (rapid eye movement) sleep and stages 3 and 4 non–REM sleep, the fragmentation index, and the incidence of apneic events.
RESULTS: This meta-analysis examined 4 trials that involved 67 subjects. Sleep efficiency was significantly higher in the PCV group than in the PSV group (mean difference 15.57%, 95% CI 8.54%–22.59%). Wakefulness was significantly lower in the PCV group than in the PSV group (mean difference −18.67%, 95% CI −30.29% to −7.04%). The percentage of REM sleep was significantly higher in the PCV group than in the PSV group (mean difference 2.32%, 95% CI 0.20%–4.45%). Among the subjects with a tendency to develop sleep apnea, the fragmentation index was significantly lower in those receiving PCV than PSV (mean difference −40.00%, 95% CI −51.12% to −28.88%). The incidence of apneic events was significantly lower in the PCV group than in the PSV group (risk ratio 0.06, 95% CI 0.01–0.45).
CONCLUSIONS: Compared with PSV, PCV may improve sleep quality in patients receiving nocturnal mechanical ventilation.
- mechanical ventilation
- pressure controlled ventilation
- assist-control ventilation
- pressure support ventilation
- sleep quality
Footnotes
- Correspondence: Ming-Chi Hu RRT, Department of Pulmonary Medicine, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe Dist., New Taipei City, 23561, Taiwan. E-mail: 20549{at}s.tmu.edu.tw
The authors have disclosed no conflicts of interest.
This work was primarily performed at the Respiratory Therapy Room, Division of Pulmonary Medicine, Department of Internal Pulmonary Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.
This manuscript was edited by Wallace Academic Editing.
Supplementary material related to this paper is available at http://rc.rcjournal.com.
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