Comparison of pressure and volume‐controlled ventilation in laparoscopic cholecystectomy operations

Aydın, Venera; Kabukçu, Hanife Karakaya; Şahin, Nursel; Mescı, Ayhan; Arici, Ayse Gulbin; Kahveci, Gulsum; Ozmete, Ozgen

doi:10.1111/crj.12223

Cited by 15 publications

(17 citation statements)

References 30 publications

(37 reference statements)

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“…VCV was associated with lower maximal plateau pressures, greater V T , and less dead-space ventilation. 86 In an observational study, the risk of PPC was higher in patients who received PCV compared with VCV, particularly with PEEP <5 cm H 2 O. 87 A meta-analysis regarding intraoperative ventilation mode in obese patients found VCV to be superior to PCV.…”

Section: Modes Of Mechanical Ventilationmentioning

confidence: 99%

Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations

Young

Harris

Vacchiano

et al. 2019

British Journal of Anaesthesia

227

218

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Postoperative pulmonary complications (PPCs) occur frequently and are associated with substantial morbidity and mortality. Evidence suggests that reduction of PPCs can be accomplished by using lung-protective ventilation strategies intraoperatively, but a consensus on perioperative management has not been established. We sought to determine recommendations for lung protection for the surgical patient at an international consensus development conference. Seven experts produced 24 questions concerning preoperative assessment and intraoperative mechanical ventilation for patients at risk of developing PPCs. Six researchers assessed the literature using questions as a framework for their review. The modified Delphi method was utilised by a team of experts to produce recommendations and statements from study questions. An expert consensus was reached for 22 recommendations and four statements. The following are the highlights: (i) a dedicated score should be used for preoperative pulmonary risk evaluation; and (ii) an individualised mechanical ventilation may improve the mechanics of breathing and respiratory function, and prevent PPCs. The ventilator should initially be set to a tidal volume of 6e8 ml kg À1 predicted body weight and positive end-expiratory pressure (PEEP) 5 cm H 2 O. PEEP should be individualised thereafter. When recruitment manoeuvres are performed, the lowest effective pressure and shortest effective time or fewest number of breaths should be used.

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Section: Modes Of Mechanical Ventilationmentioning

confidence: 99%

Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations

Young

Harris

Vacchiano

et al. 2019

British Journal of Anaesthesia

227

218

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show abstract

“…Laparoscopic surgery has been used increasingly in many surgical procedures because of the shorter hospital stay, minimal postoperative pain and rapid recovery [1]. To obtain adequate visualization and reveal surgical area, the CO2 pneumoperitoneum method is used during the operation, but the increased intra-abdominal pressure during this type of surgery may cause problems, especially with the cardiorespiratory system [2]. Various ventilatory strategies are recommended to solve this problem and achieve better oxygenation during laparoscopy.…”

mentioning

confidence: 99%

“…Additionally, it ensures collapsed alveoli open up by extending inspiratory time using adequate positive endexpiratory pressure levels [4]. Whether PCV is superior to VCV during laparoscopic surgery is still debatable [2,3,[5][6][7][8][9][10]. In some studies, VCV provides better alveolar ventilation than PCV [2], but in other studies, PCV results in better oxygenation [9].…”

mentioning

confidence: 99%

“…Whether PCV is superior to VCV during laparoscopic surgery is still debatable [2,3,[5][6][7][8][9][10]. In some studies, VCV provides better alveolar ventilation than PCV [2], but in other studies, PCV results in better oxygenation [9]. Proper comparison of the two techniques is difficult as the relevant randomized controlled trials (RCTs) are small sample (the largest published trial is only 102 patients).…”

mentioning

confidence: 99%

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Comparison of Pressure- and Volume-Controlled Ventilation in Laparoscopic Surgery: A Meta-analysis of Randomized Controlled Trial

Wang¹,

Wang²,

Liu³

et al. 2015

CIM

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Purpose: Volume-controlled ventilation (VCV) has been the traditional mechanical ventilation mode in laparoscopic surgery. Pressure-controlled ventilation (PCV) has been used more frequently in recent years, especially for patients with complicated conditions; however, evidence on whether PCV is superior to VCV is still lacking. A meta-analysis was used to compare the effects of PCV and VCV on respiratory and hemodynamic parameters during laparoscopic surgery. Methods: PubMed and Embase were each searched from their inception to December 2014 for randomized controlled trials comparing the effects of PCV and VCV on respiratory and hemodynamic parameters during laparoscopic surgery. Standard mean difference (SMD) with 95% confidence interval (CI) was calculated using a random effect model. Outcomes were assessed at three times: preoperative (T1), intraoperative (T2) and postoperative (T3). Respiratory mechanics (including peak airway pressure, plateau pressure, mean airway pressure, compliance, airway resistance, minute volume, end-tidal CO2 tension and tidal volume) and hemodynamic parameters (including heart rate and mean arterial pressure) were calculated. Results: Eight randomized controlled trials with a total of 428 participants, 214 cases using PCV and 214 cases using VCV, were included in the meta-analysis. No significant differences were detected between the groups in terms of hemodynamic parameters. In contrast, with respiratory mechanics, PCV was slightly but significantly associated with lower peak airway pressure, higher compliance, lower airway resistance at T1, lower peak airway pressure, higher compliance, higher mean airway pressure at T2, lower peak airway pressure, lower mean airway pressure and higher end-tidal CO2 tension at T3. For the rest of respiratory parameters, there were no statistical differences between the groups. Subgroup analysis by morbidly obese, type of operations and quality of studies, showed similar results. Conclusions: Our meta-analysis suggests that hemodynamic parameters are similar in patients who underwent laparoscopic surgery with PCV and VCV, but patients who had PCV exhibited mildly better respiratory data.

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“…We read with interest the above study by Aydın et al (1), which provided a comparison between pressurecontrolled ventilation (PCV) and volume-controlled ventilation (VCV) during laparoscopic cholecystectomy surgery on the effects of intraoperative pneumoperitoneum on haemodynamic data, respiratory parameters and arterial blood gas readings. The study found that haemodynamic variables were unchanged between the two groups but that VCV at 8-10 mL/kg resulted in higher tidal volumes (TVs) being attained and achievement of lower alveolararterial oxygen gradients than ventilation PCV.…”

mentioning

confidence: 99%

Pressure vs controlled mode in laparoscopy cholecystectomy? Still more questions that answers

Glossop

Esquinas

2015

Clinical Respiratory J

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Comparison of pressure and volume‐controlled ventilation in laparoscopic cholecystectomy operations

Cited by 15 publications

References 30 publications

Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations

Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations

Comparison of Pressure- and Volume-Controlled Ventilation in Laparoscopic Surgery: A Meta-analysis of Randomized Controlled Trial

Pressure vs controlled mode in laparoscopy cholecystectomy? Still more questions that answers

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