Background: This study was targeted toward comparing volume-guaranteed (VG) ventilation with conventional pressure-controlled (PC) ventilation in preterm infants with respiratory distress syndrome (RDS) in terms of the facilitation of weaning and extubation and occurrence of complications, such as pneumothorax, intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC). Methods: This single-center randomized controlled trial was conducted on neonates who were mechanically ventilated in the Neonatal Intensive Care Unit of Kasturba Hospital Manipal Udupi, Karnataka, India. Infants with the gestational age (GA) of 27-34 weeks with RDS requiring mechanical ventilation in the first week of life were randomized to receive either SIMV-PC or SIMV-VG ventilation. Infants were stratified into two GA groups of 27-30 and 31-34 weeks. Sealed opaque envelope was used to randomize the infants into two treatment modalities. Sample size was calculated as 120 and 60 in each treatment group. Results: A total of 115 neonates were enrolled. The mean GA and birth weight of the treatment groups were 31± 2. 3 weeks and 1230± 374 g, respectively, and 70% of them received antenatal steroids. As the primary outcome variable, the total duration of ventilation was 8 h (range: 3-17) (median and IQR) in the SIMV-PC group and 6 h (range: 3-13) in the SIMV-VG group (P=0. 366). Stratified analysis of neonates with the GA of > 31-34 weeks showed a significant difference between the VG and PC ventilation groups regarding the duration of ventilation. Conclusion: There was a decrease in the duration of ventilation in VG ventilation, compared to that in PC ventilation at a higher GA. The leak was the major issue with VG ventilation in the lower GA group.

one of the most commonly encountered issues associated with open heart surgery is the extended duration of endotracheal intubation, as well as the complexity of the subsequent weaning process from mechanical ventilation. It has been demonstrated that as the period of mechanical ventilation is prolonged, patients tend to experience an increasing number of side effects and complications related to this extended support. An effective strategy during this phase is essential for facilitating patient recovery[1]

Background: Different modes of mechanical ventilation are used for respiratory support after coronary artery bypass graft (CABG). This study aimed to compare the effect(s) of using adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) on the length of mechanical ventilation (intubation duration) and hospital stay after coronary artery bypass graft surgery.Materials and Methods: In a randomized control trial, 64 patients were ventilated with ASV as the experiment group or with SIMV as the control group after CABG surgery in Chamran Hospital of Isfahan University of Medical Sciences. The time of tracheal intubation and the length of hospital stay were compared between the two groups. Data were analyzed and described using statistical analysis (independent t‑test).Results: The mean time of intubation duration was significantly lower in ASV group compared with SIMV group. (4.83 h vs 6.71 h, P < 0.001). The lengths of hospital stay in the ASV and the SIMV groups were 140.6 h and 145.1 h, respectively. This difference was significant between the two groups (P = 0.006). Conclusions: According to the results of this study, using ASV mode for mechanical ventilation after CABG led to a decrease in intubation duration and also hospital stay in comparison with the SIMV group. It is recommended to use ASV mode on ventilators for respiratory support of patients undergoing coronary artery bypass graft surgery.

Background: Suitable mechanical ventilation strategies can reduce the incidence and severity of ventilator‑ associated lung injury in patients with acute respiratory distress syndrome (ARDS). In this study, the effects of adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) on respiratory parameters and arterial blood gases (ABGs) parameters were compared in ARDS patients. Materials and Methods: Twenty‑ four patients were randomly divided into two groups of ASV and SIMV. Patients were followed up for 3 days, and respiratory parameters including rapid shallow breathing index (RSBI), spontaneous breathing rate (SBR), minute volume, and peak inspiratory pressure (PIP) as the primary outcomes and ABG parameters including PaO2, FiO2, PaCO2, HCO3, and PaO2/FiO2 ratio as the secondary outcomes were measured. Results: PIP in patients in the SIMV group on the 1st day (P = 0. 013), 2nd day (P = 0. 001), and 3rd day (P = 0. 004) was statistically significantly more compared to those in patients in the ASV group. RSBI, SBR, and minute volume between the ASV and SIMV groups during the 3 days were not statistically significantly different (P > 0. 05). The mean arterial blood pressure, heart rate, PaO2, and PH between both groups were similar (P > 0. 05). At the end of the 2nd and 3rd days, the level of FiO2 and PaCO2 in ASV was significantly lower than those in ASV group. HCO3 in each of the 3 days in the ASV group was statistically significantly lower than that in the SIMV group (P < 0. 050). PaO2/FiO2 ratio in patients in the ASV group in the 3 days was statistically significantly higher than that in the SIMV group (P < 0. 050). Conclusion: By reducing PIP and improving oxygenation and ABG parameters, ASV mode may be a safe and feasible mode during mechanical ventilation in patients with ARDS.

Background: Appropriate respiratory support is crucial for improving the clinical outcomes of critically ill patients infected with the SARS-CoV-2 virus. This study aimed to investigate the different modalities of respiratory support and clinical outcomes in patients with COVID-19 in intensive care units (ICUs). Materials and Methods: In a retrospective study, we enrolled 290 critically ill COVID-19 patients who were admitted to the ICUs of four hospitals in Mazandaran, northern Iran. Data were extracted from the medical records of all included patients, from December 2019 to July 2021. Patients' demographic data, symptoms, laboratory findings, comorbidities, treatment, and clinical outcomes were collected. Results: 46. 55% of patients died. Patients with ≥, 2 comorbidities had significantly increased odds of death (OR=5. 88, 95%CI: 1. 97-17. 52, P=0. 001) as compared with patients with no comorbidities. Respiratory support methods such as face mask (survived=37, deceased=18, P=0. 022), a non-rebreather mask (survived=39, deceased=12, P<0. 001), and synchronized intermittent mandatory ventilation (SIMV) (survived=103, deceased=110, P=0. 004) were associated with in-hospital mortality. Duration of respiratory support in nasal cannula (survived=3, deceased=2, P<0. 001), face mask (survived=3, deceased=2, P<0. 001), a non-rebreather mask (survived=3, deceased=2, P=0. 033), mechanical ventilation (survived=5, deceased=6, P<0. 019), continuous positive airway pressure (CPAP) (survived=3, deceased=2, P<0. 017), and SIMV (survived=4, deceased=5, P=0. 001) methods were associated with higher in-hospital mortality. Conclusion: Special attention should be paid to COVID-19 patients with more than two comorbidities. As a specific point of interest, SIMV may increase the in-hospital mortality rate of critically ill patients with COVID-19 connected to mechanical ventilation and be associated with adverse outcomes.