COMPARATIVE ANALYSIS OF VOLUME-CONTROLLED VS PRESSURE-CONTROLLED VENTILATION IN ACUTE RESPIRATORY DISTRESS SYNDROME PATIENTS

Abstract

Background: Acute Respiratory Distress Syndrome (ARDS) is a major cause of acute respiratory failure with high morbidity and mortality. Mechanical ventilation is essential in ARDS management, yet inappropriate ventilatory strategies may worsen lung injury. Volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) are commonly used modes, but evidence comparing their effectiveness, particularly in resource-limited settings, remains limited. Objective: To compare the effectiveness of volume-controlled and pressure-controlled ventilation in adult patients with ARDS. Methods: This cross-sectional comparative study was conducted at Lady Reading Hospital, Peshawar, over six months. Eighty-eight adult ARDS patients requiring invasive mechanical ventilation were enrolled and equally allocated to VCV (n=44) and PCV (n=44) groups. Oxygenation parameters (SpO₂, PaO₂, PaO₂/FiO₂), lung compliance, ventilatory pressures (PIP, Pplat, MAP), and PaCO₂ were recorded at baseline, 1, 6, 12, and 24 hours. Data were analyzed using SPSS version 27.0, and independent t-tests were applied. Results: PCV was associated with significantly higher SpO₂, PaO₂, and PaO₂/FiO₂ ratios, improved lung compliance, and lower peak and plateau pressures at all time points (p < 0.001). Mean airway pressure was higher and PaCO₂ was significantly lower in the PCV group, indicating better alveolar recruitment and ventilation efficiency. Conclusion: Pressure-controlled ventilation demonstrated superior oxygenation and lung-protective advantages compared to volume-controlled ventilation in ARDS patients. PCV may be a preferable ventilatory strategy during early ARDS management.