Volume-controlled versus pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation.
10.4097/kjae.2014.67.4.258
- Author:
Seok Young SONG
1
;
Jin Yong JUNG
;
Min Su CHO
;
Jong Hae KIM
;
Tae Ha RYU
;
Bong IL KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. jychung@cu.ac.kr
- Publication Type:Original Article
- Keywords:
Airway pressure;
Arterial oxygenation;
One-lung ventilation;
Pressure-controlled ventilation-volume guaranteed
- MeSH:
Anesthesia;
Body Weight;
Bronchoscopes;
Humans;
Lung;
One-Lung Ventilation*;
Oxygen;
Propofol;
Thoracic Surgery;
Tidal Volume;
Ventilation
- From:Korean Journal of Anesthesiology
2014;67(4):258-263
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The purpose of this study was to investigate the changes in airway pressure and arterial oxygenation between ventilation modes during one-lung ventilation (OLV) in patients undergoing thoracic surgery. METHODS: We enrolled 27 patients for thoracic surgery with OLV in the lateral decubitus position. The subjects received various modes of ventilation in random sequences during surgery, including volume-controlled ventilation (VCV) and pressure-controlled ventilation-volume guaranteed (PCV-VG) with a tidal volume (TV) of 8 ml/kg of actual body weight. Target-controlled infusion (TCI) with propofol and remifentanil was used for anesthesia induction and maintenance. After double-lumen endobronchial tube (DLT) insertion, the proper positioning of the DLT was assessed using a fiberoptic bronchoscope. Peak inspiratory pressure (Ppeak), exhaled TV, and arterial blood gas were measured 30 min after each ventilation mode. RESULTS: P(peak) was significantly reduced with the PCV-VG mode (19.6 +/- 2.5 cmH2O) compared with the VCV mode (23.2 +/- 3.1 cmH2O) (P < 0.000). However, no difference in arterial oxygen tension was noted between the groups (PCV-VG, 375.8 +/- 145.1 mmHg; VCV, 328.1 +/- 123.7 mmHg) (P = 0.063). The exhaled TV was also significantly increased in PCV-VG compared with VCV (451.4 +/- 85.4 vs. 443.9 +/- 85.9 ml; P = 0.035). CONCLUSIONS: During OLV in patients with normal lung function, although PCV-VG did not provide significantly improved arterial oxygen tension compared with VCV, PCV-VG provided significantly attenuated airway pressure despite significantly increased exhaled TV compared with VCV.
