Flow Versus Volume-Controlled Ventilation in Intubated Obstructive and Asthmatic Patients

What this Trial Is About

Researchers are evaluating the effects of Flow-controlled ventilation (FCV) compared to Volume-controlled ventilation (VCV) in patients aged 18 years and older who are intubated due to an exacerbation of asthma or chronic obstructive pulmonary disease (COPD). This pilot study uses a randomized crossover design to test whether FCV can reduce the minute volume and dynamic hyperinflation in these patients, which may help decrease common complications associated with mechanical ventilation such as pneumothorax and cardiovascular collapse. Participants are mechanically ventilated using either FCV or VCV for two separate 90-minute periods, with patients randomized to begin with one mode before switching to the other. FCV delivers a low and constant flow during both inspiration and expiration, aiming to reduce airway resistance and prevent airway collapse, while VCV is set according to standard care. Measurements include flow, pressures, lung volumes, and gas exchange monitored by devices such as an electrical impedance tomography belt and an esophageal balloon. During the 180-minute study, patients receive continuous monitoring of ventilation parameters and hemodynamic status, with adjustments made to optimize compliance and carbon dioxide levels during FCV. Researchers assess the primary outcome of minute volume after 90 minutes on each ventilation mode and secondary outcomes including end-inspiratory lung volume and airway pressures. Because all patients are sedated and on mechanical ventilation, no additional discomfort is expected. The study includes safety monitoring to promptly manage any adverse events.

FCV Vs VCV in Obstructive and Asthmatic Patients