The effect of APRV-LTV mechanical ventilation mode on SpO2 and ventilation indices in patients with COVID-19

Atye Babaii; Mohammad Abbasinia; Abbas Ahmadi; Seyed Hasan Adeli; Seyed Yaser Foroghi Ghomi; Samaneh Pakzaban

doi:10.18502/npt.v10i2.12831

Atye Babaii Department of Internal Surgical Nursing, Faculty of Nursing, Qom University of Medical Sciences, Qom, Iran
Mohammad Abbasinia Department of Internal Surgical Nursing, Faculty of Nursing, Qom University of Medical Sciences, Qom, Iran
Abbas Ahmadi Department of Anesthesiology, Critical Care and Pain Medicine, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
Seyed Hasan Adeli Department of Internal Medicine, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran
Seyed Yaser Foroghi Ghomi Department of Emergency Medicine, Faculty of Medicine, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
Samaneh Pakzaban Department of Intensive Care Unit, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran

DOI: https://doi.org/10.18502/npt.v10i2.12831

Keywords: respiratory distress syndrome; COVID-19; artificial respiration; oxygen saturation; respiratory insufficiency

Abstract

Background & Aim: Mechanical ventilation is a life-saving method for acute respiratory distress syndrome. The present study aimed to investigate the impact of airway pressure release ventilation-low tidal volume mode on COVID-19 patients’ peripheral capillary oxygen saturation and ventilation indices.

Methods & Materials: This clinical trial was conducted on 70 COVID-19 patients hospitalized in the Intensive care unit in Qom, Iran. Patients were selected using convenience sampling and randomly allocated to intervention and control groups. In the control group, patients were ventilated using synchronized intermittent mandatory ventilation mode, and in the intervention group, patients were ventilated using airway pressure release ventilation-low tidal volume mode. Patients’ peripheral capillary oxygen saturation and ventilation indices were checked and recorded before and after the intervention. The data were analyzed using SPSS 11.5.

Results: According to the results of the repeated-measures ANOVA test before the intervention and the 2 and 4 hours after the intervention, there were no significant differences between the intervention and control groups regarding the fraction of inspired oxygen, volume minute per minute, and peripheral capillary oxygen saturation (P>0.05). However, in the intervention group compared to the control group, the mean of PIP was significantly reduced (P<0.05).

Conclusion: In patients with COVID-19, the two modes of mechanical ventilation, APRV, and control, had no significant differences in the fraction of inspired oxygen, volume minute per minute, and peripheral capillary oxygen saturation. However, the mean peak inspiratory pressure reduction in the intervention group was greater than that in the control group. Considering that several factors can affect peripheral capillary oxygen saturation and ventilation indices, these results should be considered with caution.