Synchronized Intermittent Mandatory Ventilation with Pressure Support versus Assist Control Ventilation in Treatment of Acute Respiratory Distress Syndrome

Mokhles, Mohamed Abd Elfattah Mohamed; Halima, Khaled; Saleh, Abdelwahab Abdelsattar; Abd El Aty, Moaz Atef

doi:10.21608/aimj.2025.410826.2730

Synchronized Intermittent Mandatory Ventilation with Pressure Support versus Assist Control Ventilation in Treatment of Acute Respiratory Distress Syndrome

Document Type : Original Article

Authors

¹ Emergency medicine and Critical care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

² Assistant professor, chest depart., faculty of medicine, Al-Azhar University

³ Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

⁴ Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

10.21608/aimj.2025.410826.2730

Abstract

Background: The ARDS Berlin definition classifies acute respiratory distress syndrome (ARDS) as a sudden worsening of lung damage due to several illness types.
Aim: In the management of patients with acute respiratory distress syndrome (ARDS), we aim to evaluate the efficacy of assist control ventilation (ACV) in comparison to synchronized intermittent mandatory ventilation with pressure support (SIMV+PS).
Subjects and methods: Participating in this prospective randomized controlled open label trial that included acute respiratory distress syndrome (ARDS) were fifty patients admitted to the critical care unit of the emergency medicine and critical care departments at Bab El-Shaareya, Al-Azhar University Hospital in Egypt from May 2023 to May 2025.
Results: Group A had considerably lower PaCO2 and FiO2 than group B at 2, 12, 24, 36, 48, and 72 hours. There was no statistically significant difference in PaO2 between the two groups at various time points. Group A had a considerably higher PaO2/FiO2 ratio than group B at 2, 12, 24, 36, 48, and 72 hours. The ratio of P/F was noticeably different in the two groups. Group A had a substantially lower PEEP compared to group B. The two groups did not differ significantly with respect to total ventilator days, intensive care unit days, hospital stay, delirium, or mortality rate.
Conclusion: In patients with ARDS, SIMV+PS showed superior outcomes in terms of PaCO2, FiO2, and PaO2/FiO2 ratio, indicating better oxygenation and ventilation efficiency. However, the modes did not differ significantly in terms of clinical outcomes like ICU stay, delirium, or mortality.

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