"Comparison of Airway Pressure Release Ventilation versus Pressure Regulated Volume Control mode of ventilation in the exploratory laparotomy patients in intensive care unit"

Mechanical ventilation is applied as one of the life support interventions in post-surgical patients with acute respiratory failure in the intensive care unit. Mechanical ventilators are equipped with unique modes to achieve optimum cardiopulmonary functions. With various preset target values, the advanced modes automatically adjust according to the patient‘s mechanical and ventilatory parameters, hence known as closed-loop control modes. Airway pressure release ventilation (APRV) is designed to facilitate the constant recruitment of alveoli while reducing the probability of ventilator-induced lung injury; while Pressure-regulated volume control (PRVC) is a dual mode of mechanical ventilation that integrates volume and pressure-control ventilation and is also termed as volume-targeted synchronized mode. On search of literature, no previous studies have compared APRV with more establish PRVC mode of ventilation specifically in postoperative exploratory laparotomy patients requiring invasive mechanical ventilatory support. We hypothesize that post-exploratory laparotomy patients in the ICU requiring mechanical ventilation with distinct and complex cardiorespiratory pathophysiology will have superior efficacy and safety in terms of ventilatory and hemodynamic profile on advance APRV mode compared to volume-targeted PRVC mode, due to the unique intrinsic characteristics of the APRV mode.