Dr Chen is affiliated with the Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan. Dr Chen, Mr Lee, and Mr Hu are affiliated with the Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. Dr Chen is affiliated with the Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan. Mss Lee and Hu are affiliated with the Respiratory Therapy Room, Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. Dr Tam is affiliated with the Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. Dr Tam is affiliated with the Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan. Dr Tam is affiliated with the Cochrane Taiwan, Taipei Medical University, Taipei City, Taiwan.
Respir Care. 2024 Mar 27;69(4):482-491. doi: 10.4187/respcare.11505.
Patients receiving mechanical ventilation commonly experience sleep fragmentation. The present meta-analysis compared the effects of pressure controlled ventilation (PCV) and pressure support ventilation (PSV) on sleep quality.
We conducted a search of the PubMed, Embase, and Cochrane Library databases for studies published before November 2023. In this meta-analysis, individual effect sizes were standardized, and the pooled effect size was determined by using random-effects models. The primary outcome was sleep efficiency. The secondary outcomes were wakefulness, percentages of REM (rapid eye movement) sleep and stages 3 and 4 non-REM sleep, the fragmentation index, and the incidence of apneic events.
This meta-analysis examined 4 trials that involved 67 subjects. Sleep efficiency was significantly higher in the PCV group than in the PSV group (mean difference 15.57%, 95% CI 8.54%-22.59%). Wakefulness was significantly lower in the PCV group than in the PSV group (mean difference -18.67%, 95% CI -30.29% to -7.04%). The percentage of REM sleep was significantly higher in the PCV group than in the PSV group (mean difference 2.32%, 95% CI 0.20%-4.45%). Among the subjects with a tendency to develop sleep apnea, the fragmentation index was significantly lower in those receiving PCV than PSV (mean difference -40.00%, 95% CI -51.12% to -28.88%). The incidence of apneic events was significantly lower in the PCV group than in the PSV group (risk ratio 0.06, 95% CI 0.01-0.45).
Compared with PSV, PCV may improve sleep quality in patients receiving nocturnal mechanical ventilation.
接受机械通气的患者通常会经历睡眠片段化。本荟萃分析比较了压力控制通气（PCV）和压力支持通气（PSV）对睡眠质量的影响。
我们在 PubMed、Embase 和 Cochrane 图书馆数据库中检索了截至 2023 年 11 月之前发表的研究。在这项荟萃分析中，个体效应量进行了标准化，使用随机效应模型确定了汇总效应量。主要结局是睡眠效率。次要结局是觉醒、快速眼动（REM）睡眠和非快速眼动（NREM）睡眠第 3 期和第 4 期的百分比、片段指数以及呼吸暂停事件的发生率。
这项荟萃分析纳入了 4 项涉及 67 名受试者的研究。PCV 组的睡眠效率明显高于 PSV 组（平均差异 15.57%，95%CI 8.54%-22.59%）。PCV 组的觉醒明显低于 PSV 组（平均差异-18.67%，95%CI -30.29%至-7.04%）。PCV 组的 REM 睡眠百分比明显高于 PSV 组（平均差异 2.32%，95%CI 0.20%-4.45%）。在有睡眠呼吸暂停倾向的受试者中，接受 PCV 的患者的片段指数明显低于接受 PSV 的患者（平均差异-40.00%，95%CI -51.12%至-28.88%）。PCV 组的呼吸暂停事件发生率明显低于 PSV 组（风险比 0.06，95%CI 0.01-0.45）。
与 PSV 相比，PCV 可能会改善接受夜间机械通气的患者的睡眠质量。
