Comparison of Different Tidal Volumes for Ventilation in Patients with an Acute Traumatic Cervical Spine Injury

Background: There is scant literature comparing high tidal volume ventilation (HTV) over low tidal volume (LTV) ventilation in acute traumatic cervical spinal cord injury (CSCI). Objective: The aim of this prospective randomized controlled parallel-group, single-blinded study was to compare the effe...

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Vydáno v:	Neurology India Ročník 70; číslo 8; s. 282 - 287
Hlavní autoři:	Sengupta, Deep, Bindra, Ashish, Kapoor, Indu, Mathur, Purva, Gupta, Deepak, Khan, Maroof
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	India Wolters Kluwer India Pvt. Ltd 01.09.2022 Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd
Témata:	Acute Disease Artificial respiration Barotrauma Care and treatment Cervical Vertebrae - injuries Complications and side effects Health aspects Humans Injuries Measurement Methods Mortality Neck Neck Injuries - complications Prevention Prospective Studies Pulmonary ventilation Respiration, Artificial - adverse effects Respiration, Artificial - methods Respiratory Insufficiency - etiology Respiratory Insufficiency - physiopathology Respiratory Insufficiency - therapy Risk factors Single-Blind Method Spinal cord injuries Spinal Cord Injuries - etiology Spinal Cord Injuries - therapy Spinal Injuries - complications Spinal Injuries - therapy Tidal Volume - physiology Ventilators India and duration of hospital stay with HTV (12-15 mL/kg) ventilation compared to LTV (6-8 mL/kg) ventilation in acute CSCI ventilation mortality high tidal volume ventilator-free breathing weaningKey Message: There is no significant difference in days to achieve ventilator-free breathing low tidal volume Cervical spine injury weaning
ISSN:	0028-3886, 1998-4022, 1998-4022
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Shrnutí:	Background: There is scant literature comparing high tidal volume ventilation (HTV) over low tidal volume (LTV) ventilation in acute traumatic cervical spinal cord injury (CSCI). Objective: The aim of this prospective randomized controlled parallel-group, single-blinded study was to compare the effect of two different tidal volumes (12-15 mL/kg and 6-8 mL/kg) in CSCI on days to achieve ventilator-free breathing (VFB), PaO2/FIO2 ratio, the incidence of complications, requirement of vasopressor drugs, total duration of hospital stay, and mortality. Materials and Methods: We enrolled patients with acute high traumatic CSCI admitted to the neurotrauma intensive care unit within 24 h of injury, requiring mechanical ventilation. Participants were randomized to receive either HTV, 12-15 mL/kg (group H) or LTV, 6-8 mL/kg (group L) tidal volume ventilation. Results and Conclusions: A total of 56 patients, 28 in each group were analyzed. Patient demographics and injury severity were comparable between the groups. VFB was achieved in 23 and 19 patients in groups H and L, respectively. The median number of days required to achieve VFB was 3 (2, 56) and 8 (2, 50) days, P = 0.33; PaO2: FIO2 ratio was 364.0 ± 64 and 321.0 ± 67.0, P = 0.01; the incidence of atelectasis was 25% and 46%, P = 0.16, respectively, in group H and group L. The hemodynamic parameters and the vasopressor requirement were comparable in both groups. There was no barotrauma. The duration of hospital stay (P = 0.2) and mortality (P = 0.2) was comparable in both groups. There was no significant difference in days to achieve ventilator-free breathing with HTV (12-15 mL/kg) ventilation compared to LTV (6-8 mL/kg) ventilation in acute CSCI. The PaO2:FiO2 ratio was higher with the use of 12-15 mL/kg. No difference in mortality and duration of hospital stay was seen in either group.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3
ISSN:	0028-3886 1998-4022 1998-4022
DOI:	10.4103/0028-3886.360926