Comparison of pressure-controlled volume-guaranteed ventilation and volume-controlled ventilation in obese patients during gynecologic laparoscopic surgery in the Trendelenburg position

Toker, Melike Korkmaz; Altıparmak, Başak; Uysal, Ali İhsan; Demirbilek, Semra

doi:10.1016/j.bjane.2019.10.002

Cited by 14 publications

(14 citation statements)

References 20 publications

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“…Combining Trendelenburg positioning with CO 2 pneumoperitoneum causes increased intrathoracic pressure [12,13], decreased lung compliance, increased Ppeak, and atelectasis [14]. Several studies have compared VCV and pressure-mediated ventilation (PCV or dual-controlled ventilation) during laparoscopic surgeries with Trendelenburg positioning; their results are consistent with our findings of lower Ppeak and higher Cdyn values in pressure-mediated ventilation [10,11,[15][16][17][18]. Although the relationship between high Ppeak and respiratory consequence is controversial, Park et al reported that their dual-controlled ventilation group showed a lower incidence of postoperative fever compared to the VCV group [11].…”

Section: Discussionsupporting

confidence: 89%

“…PCV-VG improved oxygenation in studies of patients with obesity and patients who underwent one-lung ventilation [17,26]. However, pressure-mediated ventilation did not lead to better oxygenation than VCV, despite the increased Pmean seen in the Trendelenburg position with CO2 pneumoperitoneum [11,15,16,18,23]. Pmean values were significantly higher in the PCV and PCV-VG groups than in the VCV group in the present study, but clinically low Pmean seemed to have a minimal effect in terms of improving oxygenation.…”

Section: Discussioncontrasting

confidence: 63%

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Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynecologic surgery in the Trendelenburg position

Lee¹,

Lee²,

Rhim³

et al. 2020

Int. J. Med. Sci.

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Background: Pressure-controlled ventilation volume-guaranteed (PCV-VG) is being increasingly used for ventilation during general anesthesia. Carbon dioxide (CO2) pneumoperitoneum in the Trendelenburg position is routinely used during robot-assisted laparoscopic gynecologic surgery. Here, we hypothesized that PCV-VG would reduce peak inspiratory pressure (Ppeak), compared to volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV). Methods: In total, 60 patients were enrolled in this study and randomly assigned to receive VCV, PCV, or PCV-VG. Hemodynamic variables, respiratory variables, and arterial blood gases were measured in the supine position 15 minutes after the induction of anesthesia (T0), 30 and 60 minutes after CO2 pneumoperitoneum and Trendelenburg positioning (T1 and T2, respectively), and 15 minutes after placement in the supine position at the end of anesthesia (T3). Results: The Ppeak was higher in the VCV group than in the PCV and PCV-VG groups (p=0.011). Mean inspiratory pressure (Pmean) was higher in the PCV and PCV-VG groups than in the VCV group (p<0.001). Dynamic lung compliance (Cdyn) was lower in the VCV group than in the PCV and PCV-VG groups (p=0.001). Conclusion: Compared to VCV, PCV and PCV-VG provided lower Ppeak, higher Pmean, and improved Cdyn, without significant differences in hemodynamic variables or arterial blood gas results during robot-assisted laparoscopic gynecologic surgery with Trendelenburg position.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 63%

Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynecologic surgery in the Trendelenburg position

Lee¹,

Lee²,

Rhim³

et al. 2020

Int. J. Med. Sci.

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show abstract

“…A study was done by Toker et al comparing 104 patients who underwent laparoscopic gynecologic surgery with a body mass index between 30 and 40 kg m −2 and was randomized to receive either VCV or PCV-VG ventilation. Mean PaO 2 levels were significantly higher in the PCV-VG group than in the VCV group at every time point after pneumoperitoneum in the Trendelenburg position (Toker et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison between volume-controlled ventilation and pressure-controlled volume-guaranteed ventilation in postoperative lung atelectasis using lung ultrasound following upper abdominal laparotomies: a prospective randomized study

Hassan

El-Shaer

Elbeialy

et al. 2020

Ain-Shams J Anesthesiol

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Background Atelectasis is a common side effect of general anesthesia. Prevention of lung atelectasis, carbon dioxide retention, and chest infection would improve the quality of medical care and decrease hospital stay and costs. The aim of this study was to compare the effects of volume-controlled ventilation (VCV) and pressure-controlled volume-guaranteed ventilation (PCVG) on postoperative lung atelectasis using lung ultrasound (LUS) following upper abdominal laparotomies. Results Sixty patients (male and female) scheduled for upper abdominal laparotomies. They were randomly allocated into two equal groups: Group A ( n = 30): received intraoperative volume-controlled ventilation (VCV) mode and group ( n = 30): received intraoperative pressure-controlled ventilation volume-guaranteed (PCV-VG) mode. Arterial blood samples were obtained immediately after extubation, and 30, 120, 240, and 360 min postextubation. Lung ultrasound was done intraoperatively at 30 min from induction, immediate, and 120 and after 360 min postoperatively. There was difference between two groups favoring PCV-VG group but that difference failed to be statically significant regarding arterial partial pressure of oxygen (PaO 2 ) and arterial carbon dioxide tension (PaCo 2 ) between the two groups in preoperative, immediate postoperative, and 120, 240, and 360 min postoperative. Arterial oxygen saturation (SaO 2 ) was significantly lower among patients in the VCV group immediate postextubation compared with patients in group PCV-VG ( p value = 0.009*). Although signs of atelectasis were low in group B, 36.7% of the patients showed normal lung ultrasound, 63.3% showed various abnormalities, 46.7% showed the presence of lung pulse (vertical rhythmic movement synchronous with cardiac pulsation through motionless lung), and 46.7% showed B lines (vertical lines indicate abnormal lung aeration), while 30% of the patients showed the absence of A-lines (indicates the absence of lung sliding and abnormal lung aeration). Also, some patients demonstrated more than one sign. However, there was no a significant difference between the two groups both showed atelectasis immediate, 2 h and 6 h postoperatively. Conclusion PCV-VG offered no significant advantage over VCV regarding the occurrence of the postoperative atelectasis. However, we prefer to use PCV-VG as postoperative hypoxia and atelectasis was much less in that mode. Further, large-scale studies are required to confirm these findings and to establish a definite conclusion.

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“…VCV is an ordinarily conducted mechanical ventilation in clinical practice. 7 , 8 The ventilator delivers a desired tidal volume with a constant flow rate and volume increases linearly in VCV. 3 Concerning airway pressure, it increases quasi-linearly during inspiration until a peak is reached.…”

Section: Discussionmentioning

confidence: 99%

Pressure-Controlled Volume-Guaranteed Ventilation Improves Respiratory Dynamics in Pediatric Patients During Laparoscopic Surgery: A Prospective Randomized Controlled Trial

Liu

Cao

Zhang

et al. 2021

IJGM

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Purpose Pressure-controlled volume-guaranteed (PCV-VG) combines the characteristics of pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV). It has been reported that PCV-VG decreases airway pressure and improves oxygenation among the adult group. In this study, the respiratory dynamics of PCV-VG and VCV are compared in pediatric patients ventilated with laryngeal mask airway and underwent laparoscopic hernia of the sac ligation. Patients and Methods Sixty-four pediatric patients were included in this prospective, randomized clinical trial. Pediatric patients were randomly allocated to receive VCV and PCV-VG ventilation during the general anesthesia. The hemodynamic and respiratory variables were recorded at the time when laryngeal mask airway was placed, pneumoperitoneum began, 5 mins after pneumoperitoneum began, pneumoperitoneum ended, and the operation ended respectively. The respiratory adverse events were recorded after the operation and on the first day after the operation. In this study, respiratory adverse events are defined as cough, hoarseness, hypoxemia, laryngospasm, bronchospasm, and sore throat. Results There was no statistical difference in hemodynamic variables at all time points between the two groups. Compared to the VCV group, peak airway pressure (Ppeak) and plateau airway pressure in the PCV-VG group decreased significantly. Pulmonary dynamic compliance (Cydn) in the PCV-VG group was significantly higher than that in the VCV group. The respiratory adverse events appeared to have no statistical difference between VCV and PCV groups. Conclusion PCV-VG provides a lower Ppeak and better Cydn in pediatric patients compared with the VCV group during laparoscopic surgery. The results suggested that PCV-VG may be a superior way of mechanical ventilation for pediatric patients who ventilated with laryngeal mask airway and experienced laparoscopic surgery.

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Comparison of pressure-controlled volume-guaranteed ventilation and volume-controlled ventilation in obese patients during gynecologic laparoscopic surgery in the Trendelenburg position

Cited by 14 publications

References 20 publications

Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynecologic surgery in the Trendelenburg position

Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynecologic surgery in the Trendelenburg position

Comparison between volume-controlled ventilation and pressure-controlled volume-guaranteed ventilation in postoperative lung atelectasis using lung ultrasound following upper abdominal laparotomies: a prospective randomized study

Pressure-Controlled Volume-Guaranteed Ventilation Improves Respiratory Dynamics in Pediatric Patients During Laparoscopic Surgery: A Prospective Randomized Controlled Trial

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