Ventilation of nonparalyzed patients under anesthesia with laryngeal mask airway, comparison of three modes of ventilation: Volume controlled ventilation, pressure controlled ventilation, and pressure controlled ventilation-volume guarantee

Ghabach, Maroun; Hajj, Elie M El; Dib, Rouba D El; Rkaiby, Jeanette M; Matta, M; Helou, May R

doi:10.4103/0259-1162.200238

Cited by 17 publications

(12 citation statements)

References 16 publications

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“…Furthermore, the efficacy of the use of DCV in supraglottic airway devices has not been extensively studied. Ghabach et al, in an observational study, have reported lower PAWP with PCV and PCV-VG than with VCV in patients ventilated using LMA Classic, along with no airway leaks in any ventilation mode in any of the patients [ 13 ]. These reports suggest that PCV and DCV are preferable to VCV for regulating PAWP in patients ventilated using supraglottic airway devices [ 4 , 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

AutoFlow® versus volume-controlled ventilation for laparoscopic gynecological surgery using LMA® ProSeal™: a randomized controlled trial

et al. 2021

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Background During laparoscopic gynecological surgery, increased peak airway pressure (PAWP) can cause airway leak upon ventilation with the LMA® ProSeal™. We hypothesized that compared with the use of volume-controlled ventilation (VCV), the use of the AutoFlow® mode would decrease PAWP and airway leak during laparoscopic gynecological surgery with LMA ProSeal. Methods This single-center, randomized, controlled trial allocated 80 adult women undergoing elective laparoscopic gynecological surgery to one of two groups, namely, the AutoFlow group or the VCV group. Ventilation settings for both groups were 8 ml/kg of tidal volume and 5 cmH2O of positive end-expiratory pressure, and respiratory rate was adjusted to maintain end-tidal carbon dioxide at 35–40 mmHg. Airway leak, PAWP, and other ventilatory parameters and vital signs were recorded at four timepoints (1, 1 min after insertion of the gastric tube; 2, 2 min after intravenous administration of rocuronium 0.6–0.8 mg/kg; 3, 1 min after initiation of pneumoperitoneum; and 4, 1 min after changing to the Trendelenburg position). The primary outcome was PAWP during pneumoperitoneum and in the Trendelenburg position, whereas the secondary outcomes included PAWP at other timepoints and airway leak development. We used the Mann–Whitney U test for PAWP and Fisher’s exact test for comparing airway leak among the groups. Results Data from 40 patients in the AutoFlow group and 39 in the VCV group were used for analysis. PAWP at pneumoperitoneum pressure and in the Trendelenburg position was significantly lower in the AutoFlow group than in the VCV group [median (interquartile range), 16 (15–18) cmH2O vs. 18 (17–19) cmH2O; P < 0.001]. Similarly, patients in the AutoFlow group showed lower PAWP at the other three timepoints measured. Airway leak occurred in four patients in the AutoFlow group and in two patients in the VCV group; however, this incidence was not significantly different (P = 0.68). Conclusions Even though AutoFlow ventilation decreased PAWP, it did not reduce the incidence of airway leak compared with VCV during laparoscopic gynecological surgery with the LMA ProSeal. Trial registration UMIN Clinical Trials Registry, identifier UMIN000023173.

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Section: Discussionmentioning

confidence: 99%

AutoFlow® versus volume-controlled ventilation for laparoscopic gynecological surgery using LMA® ProSeal™: a randomized controlled trial

et al. 2021

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“…P < 0.01 was considered statistically significant. The sample size was based on previous studies [ 15 ], in which the difference in mean PIP between both modes of ventilation was 3 cm H 2 O, with a standard deviation of 3 cm H 2 O. Using α of .01 and desired power of 90%, 64 participants were determined to be needed to demonstrate a statistically significant difference.…”

Section: Participants and Methodsmentioning

confidence: 99%

Use of volume controlled vs. pressure controlled volume guaranteed ventilation in elderly patients undergoing laparoscopic surgery with laryngeal mask airway

et al. 2021

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Background The peak inspiratory pressure (PIP) is crucial in mechanical ventilation with supraglottic airway device (SAD). Pressure-controlled ventilation volume-guaranteed (PCV-VG), delivering a preset tidal volume with the lowest required airway pressure, is being increasingly used during general anesthesia. In this study, we compared respiratory mechanics and circulatory parameters between volume-controlled ventilation (VCV) and PCV-VG in elderly patients undergoing laparoscopic surgery using the laryngeal mask airway supreme (LMA). Methods Eighty participants scheduled for laparoscopic surgery were enrolled in this prospective, randomized clinical trial. The participants were randomly assigned to receive VCV or PCV-VG. PIP, dynamic compliance (Cdyn) and mean inspiratory pressure (Pmean) were recorded at 5 min after induction of anesthesia (T1), 5 min after pneumoperitoneum(T2), 30 and 60 min after pneumoperitoneum (T3 and T4). Data including other respiratory variables, hemodynamic variables, and arterial blood gases were also collected. The difference in PIP between VCV and PCV-VG was assessed as the primary outcome. Results PIP was significantly lower at T2, T3, and T4 in both groups compared with T1 (all P < 0.0001), and it was significantly lower in the PCV-VG group than the VCV group at T2, T3, and T4 (all P < 0.001). Cydn was decreased at T2, T3, and T4 in two groups compared with T1 (all P < 0.0001), but it was higher in PCV-VG group than in VCV group at T2, T3, and T4 (all P < 0.0001). There were on statistically significant differences were found between the groups for other respiratory and hemodynamic variables. Conclusion In elderly patients who underwent laparoscopic surgery using an LMA, PCV-VG was superior to VCV in its ability to provide ventilation with lower peak inspiratory pressure and greater dynamic compliance.

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“…Some researchers have compared the VCV and PCV-VG ventilation among the adult group. 4 , 5 However, the effect of respiratory dynamics in pediatric patients undergoing VCV and PCV-VG ventilation with laryngeal mask airway is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Pressure-Controlled Volume-Guaranteed Ventilation Improves Respiratory Dynamics in Pediatric Patients During Laparoscopic Surgery: A Prospective Randomized Controlled Trial

Liu

Cao

Zhang

et al. 2021

IJGM

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Purpose Pressure-controlled volume-guaranteed (PCV-VG) combines the characteristics of pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV). It has been reported that PCV-VG decreases airway pressure and improves oxygenation among the adult group. In this study, the respiratory dynamics of PCV-VG and VCV are compared in pediatric patients ventilated with laryngeal mask airway and underwent laparoscopic hernia of the sac ligation. Patients and Methods Sixty-four pediatric patients were included in this prospective, randomized clinical trial. Pediatric patients were randomly allocated to receive VCV and PCV-VG ventilation during the general anesthesia. The hemodynamic and respiratory variables were recorded at the time when laryngeal mask airway was placed, pneumoperitoneum began, 5 mins after pneumoperitoneum began, pneumoperitoneum ended, and the operation ended respectively. The respiratory adverse events were recorded after the operation and on the first day after the operation. In this study, respiratory adverse events are defined as cough, hoarseness, hypoxemia, laryngospasm, bronchospasm, and sore throat. Results There was no statistical difference in hemodynamic variables at all time points between the two groups. Compared to the VCV group, peak airway pressure (Ppeak) and plateau airway pressure in the PCV-VG group decreased significantly. Pulmonary dynamic compliance (Cydn) in the PCV-VG group was significantly higher than that in the VCV group. The respiratory adverse events appeared to have no statistical difference between VCV and PCV groups. Conclusion PCV-VG provides a lower Ppeak and better Cydn in pediatric patients compared with the VCV group during laparoscopic surgery. The results suggested that PCV-VG may be a superior way of mechanical ventilation for pediatric patients who ventilated with laryngeal mask airway and experienced laparoscopic surgery.

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Ventilation of nonparalyzed patients under anesthesia with laryngeal mask airway, comparison of three modes of ventilation: Volume controlled ventilation, pressure controlled ventilation, and pressure controlled ventilation-volume guarantee

Cited by 17 publications

References 16 publications

AutoFlow® versus volume-controlled ventilation for laparoscopic gynecological surgery using LMA® ProSeal™: a randomized controlled trial

AutoFlow® versus volume-controlled ventilation for laparoscopic gynecological surgery using LMA® ProSeal™: a randomized controlled trial

Use of volume controlled vs. pressure controlled volume guaranteed ventilation in elderly patients undergoing laparoscopic surgery with laryngeal mask airway

Pressure-Controlled Volume-Guaranteed Ventilation Improves Respiratory Dynamics in Pediatric Patients During Laparoscopic Surgery: A Prospective Randomized Controlled Trial

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