Pressure Control Ventilation

Nichols, Dane; Haranath, Sai Praveen

doi:10.1016/j.ccc.2006.12.005

Cited by 59 publications

(45 citation statements)

References 58 publications

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“…PCV was always used to avoid higher airway pressure and provide better oxygenation (14). From previous studies we found that the controversy on better performance of PCV over VCV really existed.…”

Section: Discussionmentioning

confidence: 99%

“…PCV generates a square pressure waveform with a decelerating inspiratory flow pattern which leads to a more even distribution of VT, recruitment of insufficiently ventilated lung units and oxygenation improvement (14,17,18). Additionally, the rapid alveolar inflation caused by the high initial flow rate in PCV can avoid regional overdistension and lead to better ventilation perfusion matching (19).…”

Section: Discussionmentioning

confidence: 99%

“…Among these four factors what we anesthesiologist can intervene was to optimize the intraoperative ventilatory pressure and limit intraoperative fluid infusion. In this study we focused on the intraoperative ventilatory pressure and we wanted to figure out the difference of patients' outcome between two commonly used ventilator modes during OLV.PCV was always used to avoid higher airway pressure and provide better oxygenation (14). From previous studies we found that the controversy on better performance of PCV over VCV really existed.…”

mentioning

confidence: 99%

“…It delivers the preset VT with the lowest possible pressure. Unfortunately in our center we did not have such new mode in our anesthesia machine, so we adjusted the pressure manually to obtain the same volume as PCV-VG did.PCV generates a square pressure waveform with a decelerating inspiratory flow pattern which leads to a more even distribution of VT, recruitment of insufficiently ventilated lung units and oxygenation improvement 14,17,18). Additionally, the rapid alveolar inflation caused by the high initial flow rate in PCV can avoid regional overdistension and lead to better ventilation perfusion matching (19).…”

mentioning

confidence: 99%

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Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for video-assisted thoracoscopic lobectomy

Zhu¹,

Fang²,

Ling³

et al. 2017

J. Thorac. Dis.

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Background: It is controversial as to which ventilation mode is better during one-lung ventilation (OLV). This study was designed to figure out whether there was any difference between volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) on oxygenation and postoperative complications under the condition of protective ventilation (PV).Methods: Sixty-five patients undergoing video-assisted thoracoscopic lobectomy were randomized into two groups. Patients in group V received VCV mode during OLV while patients in group P received PCV.The tidal volume (VT) in both groups was 6 mL per predicted body weight (PBW). Positive end-expiratory pressure (PEEP) was set at the level of 5 cmH 2 O in both groups. Arterial gas analysis were performed preoperatively with room air (T 0 ), at 15 mins (T 1 ) and 1 h (T 2 ) after OLV, at the end of OLV (T 3 ), 30 min after PACU admission (T 4 ), 24 h after surgery (post-operative day 1, POD 1 ) and 48 h after surgery (postoperative day 2, POD 2 ). Peak inspiratory airway pressure (Ppeak) and plateau airway pressure (Pplat) were recorded at T 1 , T 2 and T 3 . The perioperative complications were also recorded.Result: Sixty-four patients completed this study. Ppeak in group V was significantly higher than that in group P (T 1 22.3±2.9 vs. 18.7±2.1 cmH 2 O; T 2 22.2±2.8 vs. 18.7±2.6 cmH 2 O). There were no differences with Pplat and intraoperative oxygenation index (T 1 203.3±109.7 vs. 198.1±93.4; T 2 216.8±79.1 vs. 232.1±101.4).The postoperative oxygenation index (T 4 525.0±160.9 vs. 520.7±127.1, post-operative day 1 (POD 1 ) 452.1±161.3 vs. 446.1±109.1; post-operative day 2 (POD 2 ) 403.8±93.4 vs. 396.7±92.8) and postoperative complications were also comparable between these two groups.Conclusions: When they were utilized during OLV, PCV and VCV had the same performance on the intraoperative oxygenation and postoperative complications under the condition of PV. J Thorac Dis 2017;9(5):1303-1309 jtd.amegroups.com ventilation (PCV) with low VT (6 mL/kg) was associated with lower incidence of postoperative lung dysfunction than volume controlled ventilation (VCV) with large VT (10 mL/kg). In 2007, Schultz et al. (5) published recommendations on intraoperative VT and suggested utilizing lower VT (≤6 mL/kg) in patients with abnormal lungs and/or risk factors for ALI.With further studying of small VT ventilation, some new findings came out. Blum et al. (6) showed that the incidence of postoperative ARDS was 0.2% in a general surgical population and the intraoperative risk factor included driver pressure instead of low tide volume. In thoracic surgery, the expected incidence of postoperative ALI was as high as 4.2% (7) and the independent risk factors included intraoperative ventilatory pressure index instead of VT. designed a study to prove their hypothesis that higher VT would be associated with higher risk of respiratory failure secondary to ALI, but the result showed that mean first hour peak airway pressure but not VT was associated with ALI. The clinical resea...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for video-assisted thoracoscopic lobectomy

Zhu¹,

Fang²,

Ling³

et al. 2017

J. Thorac. Dis.

View full text Add to dashboard Cite

show abstract

“…Development of our understanding of pressure volume curves and the recent demonstration of microscopic shear stress lung injury have changed the whole concept of safe lung with pressure and volume approach in mechanical ventilation. 2 The traditional approach of using large tidal volume in volume control ventilation in the trauma patients with central nervous system trauma injury or abdominal trauma injury causes cardiovascular embarrassment, risk of peak inspiratory pressure and plateau pressure without significant improvement in the arterial oxygenation. 3 More over high tidal volume causes excessive stretch of non dependant lung region and promotes alveolar rupture, leading to the volume trauma of the lungs.…”

mentioning

confidence: 99%