Use of pressure-regulated volume control in the first 48 hours of hospitalization of mechanically ventilated patients with sepsis or septic shock, with or without ARDS

Abstract

Purpose: To evaluate the impact of pressure-regulated volume control (PRVC/VC+) use on delivered tidal volumes in patients with acute respiratory distress syndrome (ARDS) or at risk for ARDS. Materials and methods: Retrospective study of mechanically ventilated adult patients with severe sepsis or septic shock. Results: A total of 272 patients were divided into patients with recognized ARDS, patients without ARDS, and patients with unrecognized ARDS. Over 90% of patients were ventilated with PRVC on admission, resulting in delivered tidal volumes significantly higher than set tidal volumes among all groups at all time points, even after ARDS recognition (p < 0.001). Tidal volumes were lower for patients with pulmonary sepsis as compared to those with a nonpulmonary origin (p < 0.001). Conclusions: Using PRVC promotes augmented delivered tidal volumes, often in excess of 6 mL/kg ideal body weight. Correct recognition of ARDS and having pulmonary sepsis improves compliance with low-stretch protocol ventilation.