A comparative study of volume control ventilation versus pressure control ventilation in patients of trauma

Background: Trauma patients may require mechanical ventilation secondary to the respiratory centre depression or acute respiratory distress syndrome (ARDS). It has become increasingly accepted that mechanical ventilation, although often life-saving, can contribute to lung injury. This concept has led to implementation of lung protective ventilation strategies.Methods: This is a prospective, double blind, comparative study in which sixty patients of intubated trauma patients on mechanical ventilation expected at least for five days are included. They were divided in group V where patients were put on volume control ventilation for four days and group-P where patients were put on volume control for two days and pressure control for next two days, after initial stabilization. Each patient was evaluated for ventilation parameters (partial pressure of oxygen, partial pressure of carbon dioxide, peak inspiratory pressure), chest X ray findings and outcome of the patient, keeping the hemodynamic stability and medications same in all patients of both groups.Results: The demographic data like age, weight, and sex were comparable in both volume and pressure control groups.. Baseline ventilation parameters were compared between the groups at every eight hours. During the study we found that there was significant and better oxygenation in pressure control ventilation than volume, less increase in peak inspiratory pressure in pressure controlled ventilation than volume controlled. Other parameters like partial pressure of carbon dioxide also showed less increase in pressure control ventilation. Chest X ray finding showed that the data is comparable and statistically not significant in both the groups. The outcomes of the patients were good in pressure control mode of ventilation than volume control mode and the data was statistically significant.Conclusions: We conclude a better compliance of patients and good respiratory outcome on pressure control than volume. It has better lung compliance with respect to partial pressures of O2 and CO2 and peak inspiratory pressures than the volume control

A comparative study of volume control ventilation versus pressure control ventilation in patients of trauma

Background: Trauma patients may require mechanical ventilation secondary to the respiratory centre depression or acute respiratory distress syndrome (ARDS). It has become increasingly accepted that mechanical ventilation, although often life-saving, can contribute to lung injury. This concept has led to implementation of lung protective ventilation strategies.Methods: This is a prospective, double blind, comparative study in which sixty patients of intubated trauma patients on mechanical ventilation expected at least for five days are included. They were divided in group V where patients were put on volume control ventilation for four days and group-P where patients were put on volume control for two days and pressure control for next two days, after initial stabilization. Each patient was evaluated for ventilation parameters (partial pressure of oxygen, partial pressure of carbon dioxide, peak inspiratory pressure), chest X ray findings and outcome of the patient, keeping the hemodynamic stability and medications same in all patients of both groups.Results: The demographic data like age, weight, and sex were comparable in both volume and pressure control groups.. Baseline ventilation parameters were compared between the groups at every eight hours. During the study we found that there was significant and better oxygenation in pressure control ventilation than volume, less increase in peak inspiratory pressure in pressure controlled ventilation than volume controlled. Other parameters like partial pressure of carbon dioxide also showed less increase in pressure control ventilation. Chest X ray finding showed that the data is comparable and statistically not significant in both the groups. The outcomes of the patients were good in pressure control mode of ventilation than volume control mode and the data was statistically significant.Conclusions: We conclude a better compliance of patients and good respiratory outcome on pressure control than volume. It has better lung compliance with respect to partial pressures of O2 and CO2 and peak inspiratory pressures than the volume control

Formulation and Evaluation of Spray-Dried Esomeprazole Magnesium Microspheres

Purpose: To prepare and evaluate in vitro mucoadhesive esomeprazole magnesium microspheres for the treatment of Zollinger Ellison syndrome. Methods: The microspheres were prepared by spray drying technique using locust bean and xanthan gums as polymers. Esomeprazole magnesium was entrapped in the microspheres at various polymer/cross-linking ratios. Glutaraldehyde was used to cross-link the gums. The microspheres were evaluated for their micromeritic properties and in vitro release. as well as by Fourier transform infrared (FTIR), differential scanning calorimetry (DSC) and scanning electron microscopy (SEM). Results: The microspheres were discrete, spherical, and showed good drug entrapment efficiency (60.5 - 92.3 %). FTIR and DSC results indicate that the drug was compatible with the polymers used. Amongst all the formulations, F6 (drug:locust bean gum:xanthan gum, 1:2:2) showed the most suitable sustained release properties with 99.8 % of drug released at the end of 12 h. Conclusion: Microspheres prepared using locust bean and xanthan gums can be used as a sustained release delivery system for esomeprazole magnesium

Bibliometric Review of Blended Finance and Partial Risk Guarantee: Establishing Needs and Advantages

A partial risk guarantee (PRG) is one of the critical instruments in the blended finance approach that provides partial assurance to the risk investor to lend leveraged capital to the borrower. Under the PRG scheme, philanthropic capital is employed as a risk guarantee to create financial and economic additionality through the multiplier effect. This study examines the current trends in PRG and blended finance ecosystem research. This study also aims to identify future research areas to work upon. The bibliometric analysis highlights the need and advantages of blended finance and PRG. The study highlights themes, such as climate finance, SDGs, impact investments, and blended finance/PRGs, from the literature on blended finance. This study illustrates the impact for researchers and managers regarding the future direction to undertake and the domains where PRG can work wonders. The research allows for a comprehensive view of the leading trends, such as utilising blended finance tools such as PRG in funding the work in climate financing, SDGs, water, sanitation, and impact investment. This is perhaps the first study to conduct a bibliometric analysis of the developing area of blended finance partial risk guarantee literature to highlight its importance and advantages