Comparison of volume-controlled ventilation mode and pressure-controlled ventilation with volume-guaranteed mode in the prone position during lumbar spine surgery

Abstract

Background During lumbar spine surgery, patients are placed in the prone position for surgical access. The prone position has various effects on cardiac and pulmonary function, including a decreased cardiac index (CI), decreased dynamic lung compliance (Cdyn), and increased peak inspiratory pressure (Ppeak). In this study, we compared the volume-controlled ventilation mode (VCV) and pressure-controlled ventilation with volume guaranteed mode (PCV-VG) based on hemodynamic and pulmonary variables in the prone position during lumbar spine surgery. Methods Thirty-six patients scheduled for lumbar spine surgery in the prone position were enrolled in this prospective, randomized clinical trial. The patients were randomly assigned to receive VCV or PCV-VG. Hemodynamic variables, respiratory variables, and arterial blood gases were measured in the supine position 15 min after the induction of anesthesia, 15 min after placement in the prone position, 30 min after placement in the prone position, and 15 min after placement in the supine position at the end of anesthesia. Results The hemodynamic variables and arterial blood gas results did not differ significantly between the two groups. Lower Ppeak values were observed in the PCV-VG group than in the VCV group ( p = 0.045). The Cdyn values in the VCV group were lower than those in the PCV-VG group ( p = 0.040). Conclusion PCV-VG led to lower Ppeak and improved Cdyn values compared with VCV, showing that it may be a favorable alternative mode of mechanical ventilation for patients in the prone position during lumbar spine surgery. Trial registration The study was retrospectively registered at ClinicalTrials.gov (NCT 03571854). The initial registration date was 6/18/2018.

Comparison between volume-controlled ventilation and pressure-controlled volume-guaranteed ventilation in postoperative lung atelectasis using lung ultrasound following upper abdominal laparotomies: a prospective randomized study

“…Another agreement with our study, Lee et al, showed that arterial blood gas results did not differ significantly between the two groups receiving (PCV-VG and VCV) when comparing 36 patients undergoing lumbar spine surgery in the prone position (Lee et al, 2019 ).…”

Comparison of Volume-Guaranteed or -Targeted, Pressure-Controlled Ventilation with Volume-Controlled Ventilation during Elective Surgery: A Systematic Review and Meta-Analysis

“…Of those, 351 had to be excluded, resulting in 21 publications that were full-text assessed for eligibility. Four publications had to be excluded, finally resulting in 17 studies that underwent the following qualitative evaluation [ 6 , 7 , 8 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. A flow chart of the search strategy and study selection are shown in Figure 1 .…”

Influence of Subarachnoid Anesthesia in the Prone Position on the Energy of Circulation

“…This increases power consumption by the myocardium, while his ability to do this can be in varying degrees limited. It is known that SA, performed using the same technique and reaching the same level, does not lead to circulatory disorders in some patients, while in others it causes severe destabilization [4]. The only reasonable explanation for this fact, from our point of view, is that the autoregulation of CS in different individuals is carried out with the predominance of different mechanisms, which, however, provide an adequate supply of energy to tissues under average daily loads.…”