Spraider P et al. Individualized flow-controlled ventilation compared to best clinical practice pressure controlled ventilation: a prospective randomized porcine study. Int J Crit Care 2020 Nov 25;24(1):662. doi: 10.1186/s13054-020-03325-3.

In a randomized porcine study, Spraider and colleagues demonstrated that FCV significantly improved gas exchange and maintained better lung aeration during ten hours of ventilation as compared to pressure controlled ventilation (PCV). Ventilation settings for FCV were individually optimized through compliance-guided pressure settings, while PCV settings were chosen according to the standard of care for lung-protective ventilation. Results showed a significantly better oxygenation in the FCV group (+24%, P=0.0097) and reduced paCO2 levels (-11%, P=0.006), while requiring a 53% lower minute volume (P<0.0001). Furthermore, in pigs ventilated with FCV the fraction of non-aerated lung tissue including atelectatic areas was reduced by 27% (P=0.032), with use of lower PEEP and comparable driving pressure, indicating an improved lung recruitment. This study demonstrates the applicability of compliance-guided individualization of FCV settings, allowing the optimization of ventilation based on the precise measurement of dynamic lung mechanics.