Comparison of pressure‑regulated volume control ventilation and pressure control ventilation in patients with abdominal compartment syndrome

Yin, Jie; Pan, Xin; Jia, Jue; Sun, Shi; Wan, Bing

doi:10.3892/etm.2019.7157

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…As for the patients with ACS requiring mechanical ventilation support in the ICU, pressure-regulated volume control ventilation was used as a lung protection strategy. [12] Compared with pressure control ventilation, pressure-regulated volume control ventilation provides satisfactory and stable ventilation at the lowest possible pressure level, which relieves injury by positive pressure ventilation and increases safety. PCV-VG is a mechanical ventilation mode that guarantees TV with the lowest possible pressure using decelerating flow for patients undergoing surgery.…”

Section: Discussionmentioning

confidence: 99%

Successful intraoperative management in patients with abdominal compartment syndrome induced by giant liposarcomas

Liu¹,

Hu²,

et al. 2020

Medicine

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Rationale: Giant intra-abdominal liposarcomas weighing over 20 kg often increase the intra-abdominal pressure (IAP), which has severe effects on the cardiovascular and respiratory systems. Abdominal compartment syndrome is defined typically as the combination of a raised IAP of 20 mm Hg or higher and new onset of organ dysfunction or failure. The anesthetic management and perioperative management are very challenging. Patients concerns: We presented 2 patients with rare giant growing liposarcoma of the abdomen, weighing 21 kg and over 35 kg, respectively. Circulatory management was particularly difficult in the first case, while respiratory management and massive blood loss was very challenging in the second one. Diagnosis: With a computed tomography scan and peritoneal-to-abdominal height ratio measurement, preoperatively the risk of developing intra-abdominal hypertension and abdominal compartment syndrome was recognized early in each patient. The inferior vena cava and right atrium of the first patient was compressed and malformed due to the uplifted diaphragm, while there was severe decreased lung volume and increased airway resistance, because of rare giant retroperitoneal liposarcomas in the second case. Histologic examination revealed dedifferentiated liposarcoma in both cases. Interventions: Both of the patients underwent resection surgery with multiple monitoring; transesophageal echocardiography monitoring in the first case and pressure-controlled ventilation volume guaranteed mechanical ventilation mode in both cases. Outcomes: Intraoperatively and postoperatively no cardiopulmonary complications in both patients. The first patient was discharged without any complications on postoperative day 10, and the second patient underwent another surgery because of anastomotic leakage resulting from bowel resection. Lessons: Multiple monitorings, in particular transesophageal echocardiography should be considered in patients with increased IAP due to a giant mass, while an appropriate lung protection ventilation strategy is crucial in these patients.

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Section: Discussionmentioning

confidence: 99%

Successful intraoperative management in patients with abdominal compartment syndrome induced by giant liposarcomas

Liu¹,

Hu²,

et al. 2020

Medicine

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“…Synergy between various organ systems raises the intraabdominal pressure even more, causing organ damage and IAH in a vicious cycle that ultimately leads in multiple organ failure. 17 The inability to breathe is the most severe and urgent form of organ dysfunction in ACS patients, necessitating immediate intervention. Acute kidney damage caused by IAH is another relatively common type of organ failure.…”

Section: Complications Of Acsmentioning

confidence: 99%

Intra-abdominal compartment syndrome: risk factors, complications and treatment

Almottowa

Nasser²,

Altamimi³

et al. 2022

Int J Community Med Public Health

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An elevation in intra-abdominal pressure is the clinical condition referred as abdominal compartment syndrome (ACS). The prevalence varies depending on the patient characteristics considered, exponentially rising in life-threatening situations such as trauma, shock and burn patients. The syndrome can also occur after surgical operations like abdominal organ transplantation, post-transplant kidney syndrome among various others. All physiological systems, but particularly the cardiovascular, respiratory, renal, and neurological systems, are impacted by ACS. Blood flow to numerous organs is influenced by ACS and intra-abdominal hypertension. Recognizing and identifying ACS, its risk factors, and clinical symptoms can help to lower the associated morbidity and mortality. The purpose of this research is to review the available information about ACS: risk factors, complications and treatment. ACS is a fatal condition if not diagnosed and treated timely. Patients who have undergone extensive abdominal surgery, experienced septic issues, received intensive fluid replacement, sustained abdominal trauma are at an increased risk of developing ACS. Multiple-organ failure, prolonged recovery, acute kidney injury, low cardiac output, elevated cranial pressure and respiratory distress are the complications of ACS. ACS can occur regardless of the primary diagnosis or treating medical speciality. Surgical decompression, vascular volume replacement, prokinetic drugs, efficient curarization, and percutaneous drainage of large-volume ascites are the treatment strategies for ACS. Combining the underlying disease's therapy approach, patient stabilization, and ACS management is necessary to establish the best course of care. Early detection of ACS is essential for management and the treatment of the patients.

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“…It supports the patient's respiratory function while under anesthesia, promotes gas exchange, supports recovery from anesthesia, stabilizes hemodynamics in the intensive care unit, and supports weaning to successful extubation [9,10]. Furthermore, intra-abdominal hypertension leads to decreased lung volume and lung compliance, and increased airway resistance, resulting in acute respiratory distress syndrome and eventually requiring mechanical ventilation [11].…”

Section: Introductionmentioning

confidence: 96%

Effects of pressure- and volume-controlled ventilation on the work of breathing in cats using a cuffed endotracheal tube

Niyatiwatchanchai

Thengchaisri

2021

Vet World

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Background and Aim: Mechanical ventilation is essential for supporting patients' respiratory function when they are under general anesthesia. For cats with limited lung capacity, the different effects of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) on respiratory function remain elusive. The objective of the present study was to compare the efficacy of VCV and PCV in cats under general anesthesia using a cuffed endotracheal tube (ETT). Materials and Methods: Twelve healthy cats were randomly allocated to either a VCV or PCV group. Five tidal volumes (6, 8, 10, 12, and 14 mL/kg) were randomly applied to assess the efficacy of VCV, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. Peak inspiratory pressures (4, 5, 6, 7, and 8 mmHg) were randomly applied to assess the efficacy of PCV, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. Blood pressure, gas leakages, and end-tidal CO2 were recorded from 60 trials for airway control during the use of VCV or PCV. Data were compared using Fisher's exact test with a significance level of p<0.05. Results: Leakages did not differ between VCV (1/60 events) and PCV (0/60 events; p=0.500). Hypercapnia was identified when using VCV (6/60 events) less frequently than when using PCV (7/60 events; p=0.762), but did not reach statistical significance. Hypotension (mean arterial blood pressure <60 mmHg) occurred less frequently with VCV (0/60 events) than with PCV (9/60 events; p=0.003). Moreover, VCV provided a significantly lower work of breathing (151.10±65.40 cmH2O mL) compared with PCV (187.84±89.72 cmH2O mL; p<0.05). Conclusion: VCV in cats using a cuffed ETT causes less hypotension than PCV. It should be noted that VCV provides a more stable tidal volume compared with PCV, resulting in a more stable minute volume. Nonetheless, VCV should not be used in patients with an airway obstruction because higher peak airway pressure may occur and lead to lung injury.

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Comparison of pressure‑regulated volume control ventilation and pressure control ventilation in patients with abdominal compartment syndrome

Cited by 3 publications

References 23 publications

Successful intraoperative management in patients with abdominal compartment syndrome induced by giant liposarcomas

Successful intraoperative management in patients with abdominal compartment syndrome induced by giant liposarcomas

Intra-abdominal compartment syndrome: risk factors, complications and treatment

Effects of pressure- and volume-controlled ventilation on the work of breathing in cats using a cuffed endotracheal tube

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