Effect of target-controlled pressure-controlled ventilation on percutaneous nephrolithotripsy patients under general anesthesia: a retrospective study

Tao, Yong; Ma, Guowei; Sun, Tao; Hu, Yue; Wang, Na; Ye, Yong; Zhao, Zhihui

doi:10.21037/tau-23-158

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Flow curves during mechanical ventilation provide valuable data on respiratory mechanics, patient resistance, and patient-ventilator interactions, which are essential for adjusting ventilator settings. The results in a study show that by using a flow optimization ventilation strategy, pressure control ventilation (PCV) with a goal of “zero flow at the end of inspiration” significantly improved intraoperative respiratory mechanics [ 15 ]. The underlying principle is as follows: a preset pressure level is reached in PCV with a high initial inspiratory flow at the beginning of the inspiratory process; and this pressure level decreases exponentially as the inspiratory time increases until the end of the inspiratory process.…”

Section: Introductionmentioning

confidence: 99%

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Effect of flow-optimized pressure control ventilation-volume guaranteed (PCV-VG) on postoperative pulmonary complications: a consort study

Sun,

Chen,

Tao

et al. 2024

J Cardiothorac Surg

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Background Postoperative pulmonary complications (PPCs) after one-lung ventilation (OLV) significantly impact patient prognosis and quality of life. Objective To study the impact of an optimal inspiratory flow rate on PPCs in thoracic surgery patients. Methods One hundred eight elective thoracic surgery patients were randomly assigned to 2 groups in this consort study (control group: n = 53 with a fixed inspiratory expiratory ratio of 1:2; and experimental group [flow rate optimization group]: n = 55). Measurements of Ppeak, Pplat, PETCO2, lung dynamic compliance (Cdyn), respiratory rate, and oxygen concentration were obtained at the following specific time points: immediately after intubation (T0); immediately after starting OLV (T1); 30 min after OLV (T2); and 10 min after 2-lung ventilation (T4). The PaO2:FiO2 ratio was measured using blood gas analysis 30 min after initiating one-lung breathing (T2) and immediately when OLV ended (T3). The lung ultrasound score (LUS) was assessed following anesthesia and resuscitation (T5). The occurrence of atelectasis was documented immediately after the surgery. PPCs occurrences were noted 3 days after surgery. Results The treatment group had a significantly lower total prevalence of PPCs compared to the control group (3.64% vs. 16.98%; P = 0.022). There were no notable variations in peak airway pressure, airway plateau pressure, dynamic lung compliance, PETCO2, respiratory rate, and oxygen concentration between the two groups during intubation (T0). Dynamic lung compliance and the oxygenation index were significantly increased at T1, T2, and T4 (P < 0.05), whereas the CRP level and number of inflammatory cells decreased dramatically (P < 0.05). Conclusion Optimizing inspiratory flow rate and utilizing pressure control ventilation -volume guaranteed (PCV-VG) mode can decrease PPCs and enhance lung dynamic compliance in OLV patients.

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Section: Introductionmentioning

confidence: 99%

“…“Zero flow rate at the end of inhalation” means that the inspiratory time is appropriate and slightly longer. Under this ventilation strategy, atelectasis caused by hypopnea can be effectively reduced and alveolar hyperinflation caused by hyperventilation can be avoided [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of flow-optimized pressure control ventilation-volume guaranteed (PCV-VG) on postoperative pulmonary complications: a consort study

Sun,

Chen,

Tao

et al. 2024

J Cardiothorac Surg

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Progress in the relationship between mechanical ventilation parameters and ventilator-related complications during perioperative anesthesia

Yue,

Yong

2024

Postgraduate Medical Journal

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Background Mechanical ventilation, as an important respiratory support, plays an important role in general anesthesia and it is the cornerstone of intraoperative management of surgical patients. Different from spontaneous respiration, intraoperative mechanical ventilation can lead to postoperative lung injury, and its impact on surgical mortality cannot be ignored. Postoperative lung injury increases hospital stay and is related to preoperative conditions, anesthesia time, and intraoperative ventilation settings. Method Through reading literature and research reports, the relationship between perioperative input parameters and output parameters related to mechanical ventilation and ventilator-related complications was reviewed, providing reference for the subsequent setting of input parameters of mechanical ventilation and new ventilation strategies. Results The parameters of inspiratory pressure rise time and inspiratory time can change the gas distribution, gas flow rate and airway pressure into the lungs, but there are few clinical studies on them. It can be used as a prospective intervention to study the effect of specific protective ventilation strategies on pulmonary complications after perioperative anesthesia. Conclusion There are many factors affecting lung function after perioperative mechanical ventilation. Due to the difference of human body, the ventilation parameters suitable for each patient are different, and the deviation of each ventilation parameter can lead to postoperative pulmonary complications. Inspiratory pressure rise time and inspiratory time will be used as the new ventilation strategy.

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Effects of pressure-controlled ventilation targeting end-inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position: a randomized clinical trial

Wang,

Ye,

Lin

et al. 2024

BMC Anesthesiol

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Background This study assessed the impact of pressure-controlled ventilation (PCV) focusing on end-inspiratory flow rate on the incidence of postoperative pulmonary complications (PPCs) and inflammation levels in patients undergoing spinal surgery in the prone position. Methods A total of 187 patients who underwent posterior spinal surgery were enrolled and randomly divided into 3 groups: 61 in the volume-controlled ventilation (VCV) group (group V), 62 in the PCV-volume-guaranteed (VG) group (group P1), and 64 in the PCV-VG end-expiratory zero flow rate group (group P2). Indicators including tidal volume (VT), peak airway pressure (Ppeak), and dynamic lung compliance (Cdyn) were recorded. The Ppeak, Cdyn, PETCO2, and oxygenation index (PaO2/FiO2) after intubation (T0), after prone position (T1), 60 min after prone position (T2), and after supine position at the end of surgery (T3) of the three groups were collected. Results In the within-group comparison, compared with T0, Ppeak increased at T1 − 2 in groups V and P1 (P < 0.01), whereas it decreased at T1 − 3 in group P2 (P < 0.01). Cdyn decreased at T1 − 2 and PaO2/FiO2 increased at T1 − 3 in all three groups (P < 0.01), and PaO2/FiO2 increased at T1 − 3 (P < 0.01). Compared with group V, Ppeak decreased at T0 − 3 in group P1 (P < 0.01) and at T1 − 3 in group P2 (P < 0.01), while Cdyn increased at T0 − 3 in groups P1 and P2 (P < 0.01). Compared with group P1, Ppeak was elevated at T0 (P < 0.01) and decreased at T1 − 3 (P < 0.05), and Cdyn was elevated at T0 − 3 in group P2 (P < 0.01). The total incidence of PPCs in group P2 was lower than that in group V (P < 0.01). Compared with the preoperative period, serum interleukin 6 (IL-6) and C-reactive protein (CRP) levels were increased at 24 and 72 h after surgery in group V (P < 0.01), whereas that was increased at 24 h after surgery in group P1 and group P2 (P < 0.01). Compared with group V, serum IL-6 and CRP levels were reduced at 24 h after surgery in groups P1 and P2 (P < 0.01 or < 0.05). Conclusion In patients undergoing spinal surgery in the prone position, PCV-VG targeting an end-inspiratory zero flow rate lowers the incidence of PPCs and inflammation levels.

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Effect of target-controlled pressure-controlled ventilation on percutaneous nephrolithotripsy patients under general anesthesia: a retrospective study

Cited by 3 publications

References 25 publications

Effect of flow-optimized pressure control ventilation-volume guaranteed (PCV-VG) on postoperative pulmonary complications: a consort study

Effect of flow-optimized pressure control ventilation-volume guaranteed (PCV-VG) on postoperative pulmonary complications: a consort study

Progress in the relationship between mechanical ventilation parameters and ventilator-related complications during perioperative anesthesia

Effects of pressure-controlled ventilation targeting end-inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position: a randomized clinical trial

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