Comparison of Volume-controlled and Pressure-controlled Ventilation during Laparoscopic Gastric Banding in Morbidly Obese Patients

Ventilation strategies in obese patients undergoing surgery: a quantitative systematic review and meta-analysis

“…13 In another small study including 24 patients, the result was significant in favour of VCV. 15 Finally, the largest of the three studies, including 40 patients, reported on equivalence (Fig. 3A).…”

“…19 The authors provided individual patient data on request, which enabled us to integrate them into meta-analyses. In the PCV modes, inspiratory pressure was set to achieve a tidal volume of 10 ml kg 21 ideal body weight, with an inspiratory over expiratory ratio 0.5, FI O 2 0.5, and with PEEP 5 cm H 2 O, 15 or without PEEP, 19 or was set to achieve a tidal volume of 8 ml kg 21 ideal body weight, with an inspiratory over expiratory ratio 0.5, FI O 2 0.6, and PEEP 5 cm H 2 O. 13 In each trial, VCV and PCV were always matched (i.e.…”

Respiratory Management of Perioperative Obese Patients

“…Other authors 51,52 have pointed out that subsequent studies found no advantage to PC-CMV over VC-CMV in obese surgical subjects. 53,54 Most recently, Dion et al 55 There is considerable debate concerning the appropriate tidal volume that should be set for mechanically ventilated patients, 57,58 with most studies and authors indicating that lower tidal volumes (6 -8 mL/kg predicted body weight) are safer than higher tidal volumes (10 -12 mL/kg predicted body weight). 59 Obese patients undergoing anesthesia can have drastically reduced lung volumes compared with nonobese patients.…”

Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES)

“…There is no evidence to suggest that PCV is better than volume-controlled ventilation to prevent lung injury and improve oxygenation during laparoscopic surgery, even if ''peak pressure '' is limited with PCV (LE 1b) [394,395].…”

“…The related reduced functional residual capacity, increased closing volume, and consequent atelectasis (LE 3a) [402,403] increase the risk for postoperative respiratory complications (LE 1b) [404] and prolonged length of hospital stay (LE 1b) [405]. Almarakbi et al [393] found that recruitment with the inspiratory maneuver repeated every 10 min followed by application of PEEP at 10 cmH 2 O was associated with the best intraoperative respiratory compliance, i.e., a PaCO 2 decrease and a PaO 2 increase in obese patients undergoing laparoscopic gastric banding without adverse events (LE 1b) [395].…”