Comparison of two ventilation models in protective lung ventilation strategies during bariatric surgery
10.3969/j.issn.1672-8467.2025.05.007
- VernacularTitle:两种通气模式在减重手术保护性肺通气策略中的应用比较
- Author:
Pan WU
1
;
Qiong YU
Author Information
1. 复旦大学附属华山医院麻醉科 上海 200040;威海市妇幼保健院麻醉科 威海 264200
- Publication Type:Journal Article
- Keywords:
bariatric surgery;
respiratory compliance;
pressure-controlled ventilation(PCV);
pressure-controlled ventilation-volume guaranteed(PCV-VG);
obesity
- From:
Fudan University Journal of Medical Sciences
2025;52(5):672-678
- CountryChina
- Language:Chinese
-
Abstract:
Objective The optimal ventilation mode for patients with obesity undergoing laparoscopic surgery remains unclear.We aimed to compare the effects of pressure-controlled ventilation(PCV)and pressure-controlled ventilation-volume guaranteed(PCV-VG)on perioperative oxygenation and respiratory mechanics in patients undergoing laparoscopic bariatric surgery.Methods In this prospective randomized controlled study,114 subjects who underwent laparoscopic bariatric surgery from Jan 2017 to Mar 2020 were randomly divided into PCV-VG group(n=56)or PCV group(n=54),with 4 lost to follow-up.The perioperative pulmonary mechanics and arterial blood gas results were compared between the two groups.Postoperative extubation time,the incidences of postoperative pulmonary complications(PPCs)and abnormal radiographic changes(ARCs)were also recorded.Results During intraoperative pneumoperitoneum,the pulmonary dynamic compliance(Cdyn)was significantly lower in PCV-VG group than that in PCV group(T2:P=0.022;T3:P=0.039).There were no significant differences in perioperative oxygenation index and respiratory peak pressure(Ppeak)between the two groups.Eighty-six patients(78.2%)had ARCs on the 1st day after surgery,and 10 cases(9.1%)developed PPCs.There was no significant difference in extubation time,ARCs or PPCs between the two groups.After adjustment,anesthesia duration and oxygenation index before anesthesia induction were significantly associated with extubation time.Anesthesia duration of more than 2 hours was a risk factor for postoperative ARCs.Conclusion Compared with PCV-VG mode,PCV mode provides better pulmonary Cdyn during intraoperative pneumoperitoneum for patients undergoing laparoscopic bariatric surgery.
