Lung-protective Ventilation Combined With Pressure-controlled Ventilation Volume-guaranteed in Children Undergoing One-lung Ventilation: A Randomised Controlled Trial

Abstract

The purpose of study was to evaluate the effect of lung-protective ventilation (LPV) combined with PCV-VG in children undergoing OLV. Patients were randomly assigned to the LPV combined with PCV-VG group (PCV-VG) or LPV group (volume-controlled ventilation). Both groups received tidal-volume ventilation of 8 ml kg-1 body weight during two-lung ventilation, 6 ml kg‑1 during OLV, with sustained 5 cmH2O positive end-expiratory pressure.The PCV-VG group exhibited lower PIP than the LPV group at T1 (16.8±2.3 vs. 18.7±2.7, P=0.001), T2 (20.2±2.7 vs. 22.4±3.3, P=0.001), and T3 (23.8±3.2 vs. 26.36±3.7, P=0.01). Dynamic compliance was higher in the PCV-VG group at T1, T2 , and T3 (P=0.01). After anaesthesia induction, lung aeration deteriorated, but with no immediate postoperative difference in both groups. Postoperative lung aeration improved and returned to normal from 2.5 h postextubation in both groups. No differences were observed in postoperative pulmonary complications, intra-operative desaturation, hospital stay. In paediatric patients, who underwent thoracoscopic surgery, PCV-VG combined with LPV was superior to LPV in its ability to provide ventilation with lower PIP and higher dynamic compliance. However, the long-term benefits of different ventilation strategies should be further investigated.