Volume-controlled versus pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation

Song, Seok Young; Jung, Jin Yong; Cho, Min-su; Kim, Jong Hae; Ryu, Taeha; Kim, Bong Il

doi:10.4097/kjae.2014.67.4.258

Cited by 34 publications

(29 citation statements)

References 18 publications

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“…The modified PCV ventilation we adopted here was similar with PCV-VG which was utilized in some recent papers (9,10). PCV-VG is the newest ventilation mode in anesthesia machine (16).…”

Section: Discussionmentioning

confidence: 99%

“…The first study of PCV-VG (11) and following studies on OLV in thoracic surgery (9) showed that PCV-VG provided better oxygenation and lower airway pressure, but unfortunately they did not compare the postoperative complications and prognosis. Our study not only focused on the intraoperative performance of these two ventilation modes but also during postoperative period.…”

Section: Discussionmentioning

confidence: 99%

“…Song et al (9) compared volume-controlled versus pressure-controlled ventilation-volume guaranteed mode (PCV-VG) during OLV. The result showed that in patients with normal lung function the airway pressure was lower in PCV-VG than that in VCV while the arterial oxygen tension remained the same.…”

Section: Original Articlementioning

confidence: 99%

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Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for video-assisted thoracoscopic lobectomy

Zhu¹,

Fang²,

Ling³

et al. 2017

J. Thorac. Dis.

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Background: It is controversial as to which ventilation mode is better during one-lung ventilation (OLV). This study was designed to figure out whether there was any difference between volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) on oxygenation and postoperative complications under the condition of protective ventilation (PV).Methods: Sixty-five patients undergoing video-assisted thoracoscopic lobectomy were randomized into two groups. Patients in group V received VCV mode during OLV while patients in group P received PCV.The tidal volume (VT) in both groups was 6 mL per predicted body weight (PBW). Positive end-expiratory pressure (PEEP) was set at the level of 5 cmH 2 O in both groups. Arterial gas analysis were performed preoperatively with room air (T 0 ), at 15 mins (T 1 ) and 1 h (T 2 ) after OLV, at the end of OLV (T 3 ), 30 min after PACU admission (T 4 ), 24 h after surgery (post-operative day 1, POD 1 ) and 48 h after surgery (postoperative day 2, POD 2 ). Peak inspiratory airway pressure (Ppeak) and plateau airway pressure (Pplat) were recorded at T 1 , T 2 and T 3 . The perioperative complications were also recorded.Result: Sixty-four patients completed this study. Ppeak in group V was significantly higher than that in group P (T 1 22.3±2.9 vs. 18.7±2.1 cmH 2 O; T 2 22.2±2.8 vs. 18.7±2.6 cmH 2 O). There were no differences with Pplat and intraoperative oxygenation index (T 1 203.3±109.7 vs. 198.1±93.4; T 2 216.8±79.1 vs. 232.1±101.4).The postoperative oxygenation index (T 4 525.0±160.9 vs. 520.7±127.1, post-operative day 1 (POD 1 ) 452.1±161.3 vs. 446.1±109.1; post-operative day 2 (POD 2 ) 403.8±93.4 vs. 396.7±92.8) and postoperative complications were also comparable between these two groups.Conclusions: When they were utilized during OLV, PCV and VCV had the same performance on the intraoperative oxygenation and postoperative complications under the condition of PV. J Thorac Dis 2017;9(5):1303-1309 jtd.amegroups.com ventilation (PCV) with low VT (6 mL/kg) was associated with lower incidence of postoperative lung dysfunction than volume controlled ventilation (VCV) with large VT (10 mL/kg). In 2007, Schultz et al. (5) published recommendations on intraoperative VT and suggested utilizing lower VT (≤6 mL/kg) in patients with abnormal lungs and/or risk factors for ALI.With further studying of small VT ventilation, some new findings came out. Blum et al. (6) showed that the incidence of postoperative ARDS was 0.2% in a general surgical population and the intraoperative risk factor included driver pressure instead of low tide volume. In thoracic surgery, the expected incidence of postoperative ALI was as high as 4.2% (7) and the independent risk factors included intraoperative ventilatory pressure index instead of VT. designed a study to prove their hypothesis that higher VT would be associated with higher risk of respiratory failure secondary to ALI, but the result showed that mean first hour peak airway pressure but not VT was associated with ALI. The clinical resea...

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“…The modified PCV ventilation we adopted here was similar with PCV-VG which was utilized in some recent papers (9,10). PCV-VG is the newest ventilation mode in anesthesia machine (16).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for video-assisted thoracoscopic lobectomy

Zhu¹,

Fang²,

Ling³

et al. 2017

J. Thorac. Dis.

View full text Add to dashboard Cite

show abstract

“…These dual-controlled modes deliver the preset tidal volumes with lowest optimal airway pressure, which may theoretically reduce the risk of barotrauma [17]. Although several clinical studies have suggested that dual-controlled modes enhanced oxygenation parameters with improved respiratory mechanics during OLV in general population and elderly [18][19][20], large-scale clinical trials are needed to confirm the overall pulmonary protective outcomes of these modern ventilator modes in the dependent lung during thoracic surgery.…”

Section: Resultsmentioning

confidence: 99%

A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation

Kuo

Liu

Chen

et al. 2020

Preprint

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Background: There is a major paradigm shift for intraoperative mechanical ventilator support by the introduction of lung protective ventilation strategies to reduce postoperative pulmonary complications and improve overall clinical outcomes in non-thoracic surgeries. However, there is currently a lack of standardized practice guideline for lung protection during thoracic surgeries that require one-lung ventilation (OLV). This study aimed to collect the expert opinions of the thoracic anesthesiologists in perioperative care for OLV surgery in Taiwan. Methods: This prospective cross-sectional study was undertaken in 16 tertiary hospitals in Taiwan from January to February 2019. A structured survey form was distributed across the participating hospitals and the thoracic anesthesiologists were invited to complete the form voluntarily. The survey form consisted of three parts, including the basic information of the institutional anesthesia care standards, ventilatory settings for a proposed patient receiving OLV surgery and expert opinions on OLV. Results: A total of 71 thoracic anesthesiologists responded to the survey. Double-lumen tubes are the most commonly used (93.8%) airway devices for OLV. The most commonly recommended ventilator setting during OLV is a tidal volume of 6-7 ml/kg PBW (67.6%) and a PEEP level of 4-6 cmH2O (73.5%). Dual controlled ventilator modes are used by 44.1% of the anesthesiologists. During OLV, high oxygen fraction (FiO2 >0.8) is more commonly supplemented to achieve an oxygen saturation higher than 94%. The consensus of anesthesiologists on the indices for lung protection in thoracic surgery is considerably low. Large majority of the anesthesiologists (91.5%) highly recommend that an international clinical practice guideline on the protective lung ventilation strategy for thoracic anesthesia should be established. Conclusions: This study found that the thoracic anesthesiologists in Taiwan share certain common practices in ventilator support during OLV. However, they are concerned about the lack of fundamental clinical evidences to support the beneficial outcomes of the current lung protective strategies applicable to OLV. Large-scale trials are needed to form an evidence-based clinical practice guideline for thoracic anesthesia.

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“…These dual-controlled modes deliver the preset tidal volumes with lowest optimal airway pressure, which may theoretically reduce the risk of barotrauma [12]. Although there were several clinical studies suggested that dual-controlled modes enhanced oxygenation parameters with improved respiratory mechanics during separated lung ventilation [13][14][15], large-scale clinical trials are needed to confirm the overall pulmonary protective outcomes of these modern ventilator modes in the dependent lung during thoracic surgery.…”

Section: Resultsmentioning

confidence: 99%

A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation

Kuo

Liu

Lam

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: There is a major paradigm shift for intraoperative mechanical ventilator support by the introduction of lung protective ventilation strategies to reduce postoperative pulmonary complications and improve overall clinical outcomes in non-thoracic surgeries. However, there is currently a lack of standardized practice guideline for lung protection during thoracic surgeries that require one-lung ventilation (OLV). This study aimed to collect the expert opinions of the thoracic anesthesiologists in perioperative care for OLV surgery in Taiwan.Methods: This prospective cross-sectional study was undertaken in 16 tertiary hospitals in Taiwan from January to February 2019. A structured survey form was distributed across the participating hospitals and the thoracic anesthesiologists were invited to complete the form voluntarily. The survey form consisted of three parts, including the basic information of the institutional anesthesia care standards, ventilatory settings for a proposed patient receiving OLV surgery and expert opinions on OLV.Results: A total of 71 thoracic anesthesiologists responded to the survey. Double-lumen tubes are the most commonly used (93.8%) airway devices for OLV. The most commonly recommended ventilator setting during OLV is a tidal volume of 6-7 ml/kg PBW (67.6%) and a PEEP level of 4-6 cmH2O (73.5%). Dual controlled ventilator modes are used by 44.1% of the anesthesiologists. During OLV, high oxygen fraction (FiO2 >0.8) is more commonly supplemented to achieve an oxygen saturation higher than 94%. The consensus of anesthesiologists on the indices for lung protection in thoracic surgery is considerably low. Large majority of the anesthesiologists (91.5%) highly recommend that an international clinical practice guideline on the protective lung ventilation strategy for thoracic anesthesia should be established.Conclusions: This study found that the thoracic anesthesiologists in Taiwan share certain common practices in ventilator support during OLV. However, they are concerned about the lack of fundamental clinical evidences to support the beneficial outcomes of the current lung protective strategies applicable to OLV. Large-scale trials are needed to form an evidence-based clinical practice guideline for thoracic anesthesia.

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Volume-controlled versus pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation

Cited by 34 publications

References 18 publications

Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for video-assisted thoracoscopic lobectomy

Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for video-assisted thoracoscopic lobectomy

A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation

A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation

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