Schmidt et al. Flow-Controlled Ventilation Attenuates Lung Injury in a Porcine Model of Acute Respiratory Distress Syndrome: A Preclinical Randomized Controlled Study. Crit Care Med. 2019 Dec 19. [Epub]

This randomised controlled study by the workgroup of Prof. Schumann demonstrates an increased ventilation efficiency and lung protective effects by FCV compared to VCV in an experimental model of acute respiratory distress syndrome (ARDS). With similar PEEP, peak pressures, tidal volumes and respiratory rates FCV significantly improved oxygenation (PaO2 +47%, P=0.035), while using a 26% lower minute volume (P<0.001). In the dependent lung parts FCV resulted in more normally aerated lung tissue (24% vs 10%; P=0.004) and less non-aerated lung tissue (23% vs 38%; P=0.033) as compared to VCV. Furthermore, lung damage was reduced by FCV as shown by the presence of thinner alveolar walls (5.5 µm vs 7.8 µm; P<0.001), a reduced amount of infiltrating inflammatory cells (20/field vs 32/field; P<0.001), and a higher concentration of surfactant protein A in the bronchoalveolar lavage fluid (1.1 vs 1.0; P=0.039).

The authors state that they feel confident that their results “provide evidence for an attenuated lung injury after FCV.”

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