Published: 2016-12-18

A comparative study of volume control ventilation versus pressure control ventilation in patients of trauma

Achin Gupta, Naina P. Dalvi, Bharati Tendolkar


Background: Trauma patients may require mechanical ventilation secondary to the respiratory centre depression or acute respiratory distress syndrome (ARDS). It has become increasingly accepted that mechanical ventilation, although often life-saving, can contribute to lung injury. This concept has led to implementation of lung protective ventilation strategies.

Methods: This is a prospective, double blind, comparative study in which sixty patients of intubated trauma patients on mechanical ventilation expected at least for five days are included. They were divided in group V where patients were put on volume control ventilation for four days and group-P where patients were put on volume control for two days and pressure control for next two days, after initial stabilization. Each patient was evaluated for ventilation parameters (partial pressure of oxygen, partial pressure of carbon dioxide, peak inspiratory pressure), chest X ray findings and outcome of the patient, keeping the hemodynamic stability and medications same in all patients of both groups.

Results: The demographic data like age, weight, and sex were comparable in both volume and pressure control groups.. Baseline ventilation parameters were compared between the groups at every eight hours. During the study we found that there was significant and better oxygenation in pressure control ventilation than volume, less increase in peak inspiratory pressure in pressure controlled ventilation than volume controlled. Other parameters like partial pressure of carbon dioxide also showed less increase in pressure control ventilation. Chest X ray finding showed that the data is comparable and statistically not significant in both the groups. The outcomes of the patients were good in pressure control mode of ventilation than volume control mode and the data was statistically significant.

Conclusions: We conclude a better compliance of patients and good respiratory outcome on pressure control than volume. It has better lung compliance with respect to partial pressures of O2 and CO2 and peak inspiratory pressures than the volume control.


Volume control mode, Pressure control mode, Mechanical ventilation, Trauma

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Cranshaw J, Nolan J. Airway Management after major trauma. British J Anaesthesia. 2006;6(3):124-7.

Nichols D, Haranath S. Pressure control ventilation. Critical Care Clinics. 2007;23:183-99.

Bardoczky GI, Yernault JC, Houben JJ, Hollander AA. Large tidal volume ventilation does not improve oxygenation in morbidly obese patients during anaesthesia. Anaesthesia Analogue. 1995;81:385.

Principles of Mechanical Ventilation, The ICU Book, 3 rd edition. In: Marino PL, Sutin KM, Editor. Philadelphia: Lippincott Williams and Wilkins; 2007:457-71.

Michaels AJ. Management of post traumatic respiratory failure. Critical Care Clinics. 2004;20(1):83-99.

Munoz J, Guerrero JE, Escalante JL, Palomino R, Dela CB. Pressure-controlled ventilation versus controlled mechanical ventilation with decelerating inspiratory flow. Critical Care Medicine. 1993;21(8):1143-8.

Beer JM, Tim G. Principles of artificial ventilation. Anaesthesia and Intensive Care Medicine. 2007;8(3):91-101.

Slack RS, Shucart W. Respiratory dysfunction associated with traumatic injury to the central nervous system. Clinical Chest Med. 1994;15(4):739-49.

Mccall JE, Cahill TJ. Respiratory Care of the Burn Patient. Journal Burn Care Rehab. 2005;26:200.

Rubenfeld GD, Caldwell E, Peabody E. Incidence and outcomes of acute lung injury. New England Journal Medicine. 2005;353:1685.

Wanek S, Mayberry JC. Blunt thoracic trauma: flail chest, pulmonary contusion, and blast injury. Critical Care Clinics. 2004;20:71.

Stocchetti N, Maas AIR, Chieregato A. Hyperventilation in head injury. Chest. 2005;127:1812.

Jeon WJ, Cho SY, Bang MR, Ko SY. Study on comparison of volume-controlled and pressure-controlled ventilation using a laryngeal mask airway during gynaecological laparoscopy. Korean J Anaesthesiology. 2011;60(3):167-72.

Gupta SD, Kundu SB, Ghose T, Maji S, Mitra K, Mukherjee M et al. A comparison between volume-controlled ventilation and pressure-controlled ventilation in providing better oxygenation in obese patients undergoing laparoscopic cholecystectomy; Indian J Anaesth. 2012;56:276-82.

Davis K Jr, Branson RD, Campbell RS, Porembka DT Comparison of volume control and pressure control ventilation: is flow waveform the difference? Journal of Trauma. 1996;41:808-14.

Cadi P, Guenoun T, Journois D, Chevallier JM, Diehl JL, Safran D, Pressure-controlled ventilation improves oxygenation during laparoscopic obesity surgery compared with volume-controlled ventilation. British J Anaesthesia. 2008;100:709-16.

Prella M, Feihl F, Domenighetti G. Effects of short-term pressure-controlled ventilation on gas exchange, airway pressures and gas distribution in patients with acute lung injury/ARDS: comparison with volume-controlled ventilation. Chest. 2002;122:13.

Choi EM, Sungwon N, Jiwon A, Young JO. A comparison of volume controlled and pressure controlled ventilation in steep trendelenburg position for robot assisted laparoscopic radical prostatectomy. J Clinical Anaesthesia. 2011;23:183-8.

Ogurlu, Kucuk M, Bilgin F, Sizlan A, Yanarates O, Ekserts, et al. Pressure controlled vs volume controlled ventilation during laparoscopic gynaecologic surgery. Journal Minimally Invasive Gynaecology. 2010;17(3):295-300.

Othman MM, Farid AM, Mousa SA, Sultan MA. Do hemodynamic effects of volume-controlled ventilation versus pressure- controlled ventilation in head trauma patients. 2013;4(5):223-31.

Guldager H, Nielsen SL, Carl P, Soerensen MB. A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure. Critical Care. 1997;1(2):75-7.

Unzueta MC, Casas JI, Moral MV. Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for thoracic surgery. Anesth Analg. 2007;104(5):1029-33.

Penny L, Andrews RN, Shiber JR, Killeen EJ, Roy S, Habashi NM. Early application of airway pressure release ventilation may reduce mortality in high risk patients: a systematic review of observational trauma ARDS literature. J Trauma Acute Care Surg. 2013;75(4):635-64.