The Effect of Pressure-Controlled Ventilation and Volume-Controlled Ventilation in Prone Position on Pulmonary Mechanics and Inflammatory Markers

Şenay, Hasan; Sivaci, Remziye; Kokulu, Serdar; Koca, Buğra; Bakı, Elif Doğan; Ela, Yüksel

doi:10.1007/s10753-016-0379-2

Cited by 17 publications

(16 citation statements)

References 15 publications

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“…In VCV, the ventilator delivers a constant preset tidal volume, and airway pressure is influenced by pulmonary compliance [3,4]. PCV provides a constant preset tidal volume by decelerating the flow, thereby achieving the desired tidal volume at lower Ppeak [9].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynecologic surgery in the Trendelenburg position

Lee¹,

Lee²,

Rhim³

et al. 2020

Int. J. Med. Sci.

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Background: Pressure-controlled ventilation volume-guaranteed (PCV-VG) is being increasingly used for ventilation during general anesthesia. Carbon dioxide (CO2) pneumoperitoneum in the Trendelenburg position is routinely used during robot-assisted laparoscopic gynecologic surgery. Here, we hypothesized that PCV-VG would reduce peak inspiratory pressure (Ppeak), compared to volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV). Methods: In total, 60 patients were enrolled in this study and randomly assigned to receive VCV, PCV, or PCV-VG. Hemodynamic variables, respiratory variables, and arterial blood gases were measured in the supine position 15 minutes after the induction of anesthesia (T0), 30 and 60 minutes after CO2 pneumoperitoneum and Trendelenburg positioning (T1 and T2, respectively), and 15 minutes after placement in the supine position at the end of anesthesia (T3). Results: The Ppeak was higher in the VCV group than in the PCV and PCV-VG groups (p=0.011). Mean inspiratory pressure (Pmean) was higher in the PCV and PCV-VG groups than in the VCV group (p<0.001). Dynamic lung compliance (Cdyn) was lower in the VCV group than in the PCV and PCV-VG groups (p=0.001). Conclusion: Compared to VCV, PCV and PCV-VG provided lower Ppeak, higher Pmean, and improved Cdyn, without significant differences in hemodynamic variables or arterial blood gas results during robot-assisted laparoscopic gynecologic surgery with Trendelenburg position.

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Section: Discussionmentioning

confidence: 99%

“…Volume-controlled ventilation (VCV) is the most commonly used method of ventilation during general anesthesia. It provides fixed minute ventilation and pulmonary resistance, which affect airway pressure [3]. In pressure-controlled ventilation (PCV), constant inspiratory airway pressure can be achieved by…”

Section: Introductionmentioning

confidence: 99%

Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynecologic surgery in the Trendelenburg position

Lee¹,

Lee²,

Rhim³

et al. 2020

Int. J. Med. Sci.

View full text Add to dashboard Cite

show abstract

“…Spine surgery is commonly performed with patients in the prone position. In respiratory physiology, Ppeak increases and Cdyn decreases as increased intra-thoracic pressure and abdominal pressure compromise diaphragm movement when a patient is turned to the prone position [3, 4, 13, 14]. To our knowledge, no previous study has compared VCV and PCV-VG in the prone position.…”

Section: Discussionmentioning

confidence: 99%

“…The volume-controlled ventilation mode (VCV) is commonly used during general anesthesia: the minute ventilation is fixed and airway pressure is influenced by pulmonary resistance or compliance [4]. The pressure-controlled ventilation with volume guaranteed mode (PCV-VG) has recently been introduced in the field of anesthesiology.…”

Section: Introductionmentioning

confidence: 99%

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

Lee

Kim

et al. 2019

BMC Anesthesiol

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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.

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“…These benefits are seen not only in respiratory outcomes; other PCV advantages are also being reported. Compared to the PCV group, the VCV group seemed to modulate pro-inflammatory factors such as interleukin (IL)-10,19 IL-6, and tumor necrosis factor alpha (TNFα) 14. Moreover, PCV showed reduced stress responses (decrease in cortisol levels and increase in insulin levels),19 and even improved right ventricular function 13…”

Section: Discussionmentioning

confidence: 99%

<p>Lung ultrasound score-based perioperative assessment of pressure-controlled ventilation-volume guaranteed or volume-controlled ventilation in geriatrics: a prospective randomized controlled trial</p>

Kim¹,

Won²,

Lee³

et al. 2019

CIA

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Purpose Recent studies have shown the potential benefits of pressure-controlled ventilation-volume guaranteed (PCV-VG) compared to volume-controlled ventilation (VCV), but the results were not impressive. We assessed the effects of PCV-VG versus VCV in elderly patients by using lung ultrasound score (LUS). Patients and methods Elderly patients (aged 65–90 years) scheduled for hip joint surgery were randomly assigned to either the PCV-VG or VCV group during general anesthesia. LUS and mechanical ventilator parameters were evaluated before induction, 30 mins after a semi-lateral position change, during supine repositioning before awakening, and 15 mins after arrival to the post-anesthesia care unit (PACU). Pulmonary function tests were performed before and after surgery. Other recovery indicators were also assessed in the PACU. Results A total of 76 patients (40 for PCV-VG and 36 for VCV) were included this study. Demographic data showed no significant difference between the two groups. In both groups, LUSs before induction were significantly lower than those at other time points. LUSs of the VCV group were significantly increased during perioperative periods compared with the PCV-VG group ( p =0.049). Visualized LUS modeling suggested an intuitive difference in the two groups and unequal distribution in lung aeration. Higher dynamic compliance and lower inspiratory peak pressure were observed in the PVC-VG group compared to the VCV group (33.54 vs 27.36, p <0.001; 18.93 vs 21.19, p <0.001, respectively). Postoperative forced vital capacity of the VCV group was lower than that of PCV-VG group, but this result was not significant (2.06 vs 1.79, respectively; p =0.091). The other respiratory data are comparable between the two groups. Conclusion The PCV-VG group showed better LUS compared with the VCV group. Moreover, LUS modeling in both groups suggests non-homogeneous and positional change in lung aerations during surgery. Clinical trial registration This study was registered at the UMIN clinical trials registry (unique trial number: UMIN000029355; registration number: R000033510)

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The Effect of Pressure-Controlled Ventilation and Volume-Controlled Ventilation in Prone Position on Pulmonary Mechanics and Inflammatory Markers

Cited by 17 publications

References 15 publications

Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynecologic surgery in the Trendelenburg position

Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynecologic surgery in the Trendelenburg position

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

<p>Lung ultrasound score-based perioperative assessment of pressure-controlled ventilation-volume guaranteed or volume-controlled ventilation in geriatrics: a prospective randomized controlled trial</p>

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