Pressure-controlled ventilation versus volume-controlled ventilation for adult patients with acute respiratory failure: A systematic review and meta-analysis.

BACKGROUND

There is limited data on the effectiveness of pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) in adult patients with acute respiratory failure. This study aimed to compare the effectiveness of these 2 ventilations.

METHODS

We performed a comprehensive search of 4 electronic databases, including PubMed, Central, Scopus, and CINAHL, from inception to July 14, 2023. This systematic review included randomized controlled trials that compared VCV and PCV ventilator modes in intubated adult patients with acute respiratory failure from any condition. Eligible studies were evaluated for study characteristics and outcomes. Details of study characteristics included authors, publication year, country, study aims, study design, study population, and characteristics of eligible patients: age, sex, disease severity, and comorbidities. The outcomes of interest were the incidence of barotrauma or pneumothorax and the in-hospital mortality rate. Meta-analysis with a fixed-effect model was used to pool the results of included studies.

RESULTS

There were 27 articles that were eligible; 4 articles met the study criteria. These studies included acute respiratory distress syndrome patients (3 studies) and chronic obstructive pulmonary disease patients with open heart surgery. The total patients in the VCV and PCV groups were 581 and 548, respectively. There was no significant difference in the incidence of barotrauma between the VCV and PCV groups (risk ratio = 0.79, 95% confidence interval: 0.56-1.12). The VCV group had a slightly higher mortality rate than the PCV group (risk ratio = 1.15, 95% confidence interval: 1.00-1.33).

CONCLUSIONS

PCV and VCV had no significant difference in both barotrauma incidence and mortality rate. PCV mode may have slightly lower mortality and may be a preferable ventilator mode in patients with acute respiratory distress syndrome. Further included studies may be required to confirm the results of this study.