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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Background Despite the development of numerous new modes of mechanical ventilation (MV), there is still uncertainty about the best methods for weaning from MV. Objectives To compare between three modes of MV: pressure support ventilation (PSV), volume support ventilation (VSV), and mandatory minute ventilation (MMV) in difficult weaning. Patient and methods We conducted a randomized controlled trial in 105 patients requiring MV with difficult weaning. Patients were randomized into three groups: PSV, VSV, and MMV groups. The primary outcome was the 'rate of successful weaning,' defined as successful removal of MV for at least 48 h after extubation. Results There was no significant difference in the rate of successful weaning among the three groups [number of patients (%)=13 (37.1%), 14 (40.0%), and 11 (31.4%) for PSV, VSV and MMV, respectively; P = 0.749]. However, there was significantly sme [mean ± SD weaning time (days)=7.38 ± 2.89, 7.46 ± 1.87, and 5.43 ± 1.44 for PSV, VSV, and MMV groups, respectively; P = 0.049], shorter ICU stay [mean ± SD ICU stay (days)=17.03 ± 3.33, 15.83 ± 3.43, and 15.04 ± 3.56 for PSV, VSV, and MMV groups, respectively; P = 0.018], and higher sleep hours per day in most of days (P < 0.05) in the MMV group. Additionally, there was significantly lower number of ventilator manipulations per day in MMV and VSV groups in most of days (P < 0.05). Conclusion Despite there was no difference in the rate of weaning success among the groups, MMV showed better improvements on weaning time, sleep hours, need for ventilator setting manipulation, and ICU stay.

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