This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
A mode of positive-pressure mechanical ventilation is a predetermined pattern of patient-ventilator interactions controlled by the ventilator and can include a variety of different breath types (eg, volume control, pressure control, and pressure support, all of which may include feedback control mechanisms such as adaptive pressure control).1 In this issue of Respiratory Care, Gibbs et al2 report a pilot study to see if 2 commonly used modes of ventilatory support (volume control–continuous mandatory ventilation [VC-CMV] and adaptive pressure control–CMV [APC-CMV]) could be effectively randomized and implemented in preparation for a larger comparative trial. The results demonstrate the feasibility of such a trial, but I'm left concerned about the design and value of such a trial.
VC-CMV and APC-CMV both have similar minute ventilation, PEEP, and FIO2 capabilities. VC-CMV has straightforward controls with clinicians required to set tidal volume and inspiratory flow (flow/volume targeted breaths). Because pressure is the main dependent variable, monitoring/alarm settings with VC-CMV are straightforward and based on airway pressure. VC-CMV …
Correspondence: Neil R MacIntyre MD FAARC, Duke University Medical Center, Durham, NC. E-mail: neil.macintyre{at}duke.edu
Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$30.00
Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.
