Comparison of volume-controlled ventilation and pressure-controlled ventilation volume guaranteed during laparoscopic surgery in Trendelenburg position

Assad, Osama M.; Sayed, Ayman A El; Khalil, Mohamed A.

doi:10.1016/j.jclinane.2016.03.053

Cited by 52 publications

(59 citation statements)

References 19 publications

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“…In the current study, the lack of improvement in arterial oxygenation with DCV may be attributed to comparable Pmean values with DCV and VCV because DCV uses an exponential decay pattern of inspiratory flow, similar to PCV. In a similar surgical setting (i.e., 30 • Trendelenburg position with pneumoperitoneum), PCV-VG as a type of DCV mode also did not significantly increase Pmean and PaO 2 compared with VCV [11]. Thus, the relationship between Pmean and PaO 2 in DCV mode remains unclear.…”

Section: Discussionmentioning

confidence: 96%

“…Robot-assisted laparoscopic radical prostatectomy (RALRP) is a commonly performed robotic surgery using CO 2 pneumoperitoneum and steep Trendelenburg positioning, which is usually performed in elderly patients with reduced cardiopulmonary reserve. Considering the aforementioned adverse respiratory changes during RALRP and the decline in pulmonary function in the elderly, DCV modes might improve arterial oxygenation and prevent lung injury due to high inspiratory pressure [2,11].…”

Section: Introductionmentioning

confidence: 99%

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Volume-Controlled Versus Dual-Controlled Ventilation during Robot-Assisted Laparoscopic Prostatectomy with Steep Trendelenburg Position: A Randomized-Controlled Trial

Park

Choi

et al. 2019

JCM

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Dual-controlled ventilation (DCV) combines the advantages of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV). Carbon dioxide (CO2) pneumoperitoneum and steep Trendelenburg positioning for robot-assisted laparoscopic radical prostatectomy (RALRP) has negative effects on the respiratory system. We hypothesized that the use of autoflow as one type of DCV can reduce these effects during RALRP. Eighty patients undergoing RALRP were randomly assigned to receive VCV or DCV. Arterial oxygen tension (PaO2) as the primary outcome, respiratory and hemodynamic data, and postoperative fever rates were compared at four time points: 10 min after anesthesia induction (T1), 30 and 60 min after the initiation of CO2 pneumoperitoneum and Trendelenburg positioning (T2 and T3), and 10 min after supine positioning (T4). There were no significant differences in PaO2 between the two groups. Mean peak airway pressure (Ppeak) was significantly lower in group DCV than in group VCV at T2 (mean difference, 5.0 cm H2O; adjusted p < 0.001) and T3 (mean difference, 3.9 cm H2O; adjusted p < 0.001). Postoperative fever occurring within the first 2 days after surgery was more common in group VCV (12%) than in group DCV (3%) (p = 0.022). Compared with VCV, DCV did not improve oxygenation during RALRP. However, DCV significantly decreased Ppeak without hemodynamic instability.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Volume-Controlled Versus Dual-Controlled Ventilation during Robot-Assisted Laparoscopic Prostatectomy with Steep Trendelenburg Position: A Randomized-Controlled Trial

Park

Choi

et al. 2019

JCM

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“…Montes et al (20) showed that in patients with normal preoperative lung function, the effect of arterial oxygenation is not significantly influenced by PCV or VCV, while Ppeak was lower in the PCV group, corroborating the present study. Assad et al (21) showed that PCV is superior to VCV because it provides ventilation with lower Ppeak. A study by Tugrul et al (5) indicated that PCV could improve oxygenation.…”

Section: Discussionmentioning

confidence: 99%

Effects of volume-controlled ventilation vs. pressure-controlled ventilation on respiratory function and inflammatory factors in patients undergoing video-assisted thoracoscopic radical resection of pulmonary carcinoma

Tan¹,

Song²,

Bian³

et al. 2018

J. Thorac. Dis.

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Background: The best ventilation approach for patients undergoing video-assisted thoracic surgery (ATS)for pulmonary carcinoma remains undefined. This study aimed to assess hemodynamics, airway pressure, arterial blood gas, and inflammatory factors in patients undergoing VATS for pulmonary carcinoma under volume-controlled ventilation (VCV) or pressure-controlled ventilation (PCV). Methods: This was a prospective study of 60 patients with pulmonary carcinoma treated at a tertiary center in 2015-2016. The subjects were randomized to the VCV or PCV group after anesthesia and total lung ventilation (TLV). Hemodynamics and blood gas parameters were compared between the two groups pre-OLV (one-lung ventilation) (T1) and after 30 (T2), 60 (T3), and 120 (T4) minutes of OLV. Radial artery blood was collected to measure interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α levels.Results: Hemodynamic and blood gas parameters were similar between the two groups (all P>0.05).During OLV, airway resistance (RAW) was significantly lower in the PCV group compared with the VCV 29.6±6.7 cmH2 O/L/s). Similar trends were found for peak pressure (Ppeak) and plateau pressure (Pplat). Mean pressure (Pmean) was similar between the two groups. Compared with the PCV group, TNF-α and IL-6 levels in the VCV group were significantly increased (all P<0.05). The levels of the anti-inflammatory mediator IL-10 were higher in the PCV group compared with the VCV group.Conclusions: PCV for OLV during radical resection of pulmonary carcinoma by VATS could reduce Ppeak and downregulate pro-inflammatory factors, likely decreasing airway injury.

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“…Increase in minute ventilation may be provided by using both pressure-controlled ventilation and volume-controlled ventilation. Pressurecontrolled ventilation was reported to decrease peak airway pressure and increase dynamic compliance and found superior to volume controlled ventilation by Assad et al [35] . But Balick-Weber et al [36] and Choi et al [37] reported that these two ventilation techniques are not superior to each other regarding respiratory mechanics and hemodynamics.…”

Section: Pulmonary Complicationsmentioning

confidence: 99%

Complications of robotic and laparoscopic urologic surgery relevant to anesthesia

Arslan¹,

Özgök²

2018

MIS

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How to cite this article: Arslan ME, Özgök A. Complications of robotic and laparoscopic urologic surgery relevant to anesthesia. AbstractTechnology keeps advancing in this era allowing surgery to become less invasive in many surgical sciences. Besides these technological advances, minimally invasive procedures such as laparoscopy and robotic assisted laparoscopy are preferred widely around the globe by both surgeons and patients. Because of the increasing demand to laparoscopy and robotic surgery, anesthetists also should adapt to these specific surgical procedures. Carbon dioxide (CO 2 ) insufflation is applied in these procedures in order to provide working space and exposure to target organs. CO 2 insufflation (pneumoperitoneum if applied intrabdominally) and positional maneuvers such as steep Trendelenburg position is used in urologic laparoscopy and robotic surgery, which have vital effects on patient's physiology regarding cardiovascular, respiratory, renal, ocular and neurological systems. Special positions and unique surgical tools used in these procedures may hinder vital interventions such as cardiopulmonary resuscitation and open conversion. Comprehension of these pathophysiological effects and specific considerations is crucial to detect, to prevent and to manage serious complications that may occur during surgery.

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Comparison of volume-controlled ventilation and pressure-controlled ventilation volume guaranteed during laparoscopic surgery in Trendelenburg position

Cited by 52 publications

References 19 publications

Volume-Controlled Versus Dual-Controlled Ventilation during Robot-Assisted Laparoscopic Prostatectomy with Steep Trendelenburg Position: A Randomized-Controlled Trial

Volume-Controlled Versus Dual-Controlled Ventilation during Robot-Assisted Laparoscopic Prostatectomy with Steep Trendelenburg Position: A Randomized-Controlled Trial

Effects of volume-controlled ventilation vs. pressure-controlled ventilation on respiratory function and inflammatory factors in patients undergoing video-assisted thoracoscopic radical resection of pulmonary carcinoma

Complications of robotic and laparoscopic urologic surgery relevant to anesthesia

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