Ventilator-induced barotrauma in controlled mechanical ventilation versus intermittent mandatory ventilation.

Retrospective analysis of pulmonary barotrauma incidence in 292 patients ventilated greater than or equal to 24 h was conducted. From 1971-1973, 156 patients with acute respiratory insufficiency were managed with controlled mechanical ventilation (CMV) and PEEP. During 1973-1976, 136 patients were supported with IMV and CPAP. Despite higher mean peak and end-expiratory airway pressure, the IMV-CPAP group exhibited a significantly lower incidence of ventilator-induced barotrauma; 7% vs 22% (p less than 0.01). We suspect the difference is related to fewer mechanical breaths with IMV and not to the level of end-expiratory pressure employed.