الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
In our ICU clinical practice, acute respiratory distress syndrome (ARDS) is one of the most fatal consequences in the diseases course. Furthermore, because ARDS is linked to considerable morbidity and death, it is high on the priority list for a critically ill patient.
Most intensivists face a challenge in managing ARDS, and poor ARDS assessment and management can have negative effects for patient outcomes in the ICU. Many researches have been conducted in search of new management options that may minimize mortality and ICU stays, with largely mixed results.
Many studies have been conducted to assess the best ventilatory methods for patients with ARDS with the goal of minimizing ventilator-induced lung damage (VILI), which can trigger a systemic inflammatory response, contributing to the development of multi-organ failure and mortality.
The use of conventional modalities in the care of patients with ARDS (pressure control ventilation) can sometimes clash with lung protective ventilation, which is one of the most essential lines of ventilatory therapy in ARDS. High volume ventilation, which can occur as a result of traditional methods, has been established as a risk factor for ARDS mortality.
ASV is a closed-loop ventilation mode that establishes a minimum minute ventilation in ventilated patients, whether actively or passively ventilated. Based on the user settings and patient data [patient’s predicted body weight (PBW), pressure limit, and minimum minute volume] as well as respiratory mechanics information from the ventilator monitoring system, ASV automatically produces a target ventilatory pattern (dynamic compliance and expiratory time constant). The ventilator uses automatic controls for the level of inspiratory pressure above positive end-expiratory pressure (PEEP), frequency, and inspiratory time of ventilator-initiated breaths to continually synchronize to variations in lung mechanics.
Our goal was to compare ASV to conventional ventilation as a whole ventilatory support in the management of moderate ARDS patients, as well as to evaluate ASV as a more synchronized mode of ventilation in terms of mechanical ventilation days, ICU stay days, and 7 and 28-day mortality.
The study included 68 adult male and female patients with moderate ARDS who were admitted to the Alexandria Main University Hospital’s Critical Care Department.
Patients divided into two groups:
group A: ARDS patients who were ventilated using ASV.
group B: ARDS patients who were ventilated using PCV&PSV.
Our study showed that patients were ventilated using ASV regarding reintubation, there was statistical difference with significant value among groups (p=0.021*). PCV group required Reintubation more than ASV group. Regarding Days of MV, there was also statistical difference with significant value among groups (p=0.038*). PCV group was higher in Days of MV than ASV group. However, According to Length of ICU stay, there was no statistically significant difference among groups (p=0.843).