الفهرس 
Conventional Mechanical VentilationOnly 14 pages are availabe for public view
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Abstract
Introduction: The strategy of mechanical ventilation is to improve ventilation, oxygenation, lung mechanics, and patient comfort while minimizing any associated complications. Dual modes, combining pressure limitation with guaranteed tidal volume, have been developed. Physicians are now demanding more control over gas flow than before, hence the development of active exhalation valves, dynamic inspiration valves, rise time control, automatic tube compensation and, of course, waveform analysis. New ventilators were developed using both pressure ventilation to avoid barotrauma and volume ventilation to guarantee the target volume as pressure regulated volume control. This allowed clinicians better control and regulation of both delivered tidal volume and control pressure. Aim of work: The aim of the study is to compare between the conventional modes of ventilation namely, pressure controlled mechanical ventilation, volume controlled mechanical ventilation and pressure support, and recently developed dual modes, pressure regulated volume control and volume support in terms of safety and efficacy in ventilating COPD patients. Patients and methods: This study was carried out on 150 COPD patients with respiratory failure, 119 were males and 31 females with age range from 45 years to 74 years. We divided patients into two groups: Group 1 including 75 COPD Patients ventilated by conventional modes (pressure control, volume control, and pressure support). Group 2 including 75 COPD Patients ventilated by dual modes (pressure regulated volume control and volume support) Results: Statistically significant reduction in duration of using sedation and the total durations of mechanical ventilation in dual modes compared to conventional modes. The mortality was statistically significant less in patients ventilated by dual modes. The outcome in patients with low mean airway pressure in both dual and conventional modes was better than patients with high mean airway pressure. There was no statistically significant differences as regard an impact of both comorbidity and smoking indices in the outcome of patients ventilated by either conventional or dual modes. Reduction in the development of complications in patients ventilated by dual modes. Presence of statistically significant decrease in APACHE II score of survived patients less than died, ventilated either with conventional or dual modes. APACHE II score 24 hour post extubation was statistically significant lower after ventilation by dual modes than conventional modes. The incidence of complications during mechanical ventilation in dual mode was statistically significant lower than conventional modes 20% versus 34.7% respectively. There was statistically significant decrease in the ventilator score in patients ventilated by dual modes compared with patients ventilated by conventional modes. Conclusions: Based on overall ventilation score, pressure regulating volume control / volume support (representing dual modes) are considered better than pressure control, volume control and pressure support (representing conventional modes) in terms of safety and efficacy in ventilating COPD.