Pressure-controlled versus volume-controlled ventilation during one-lung ventilation in elderly patients with poor...

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Critical Care Medicine

Background:

• Elderly patients with poor pulmonary function present unique challenges during one-lung ventilation (OLV).
• Ventilatory strategy significantly impacts gas exchange and outcomes during OLV.

Purpose of the Study:

• To compare the effects of pressure-controlled ventilation (PCV) versus volume-controlled ventilation (VCV) in elderly patients with compromised pulmonary function undergoing OLV.
• To evaluate intraoperative and postoperative oxygenation and recovery metrics between the two ventilation modes.

Main Methods:

• Elderly patients with forced expiratory volume in 1 s <1.5 L undergoing pulmonary carcinoma resection requiring at least 2 hours of OLV were enrolled.
• Patients were randomized to either VCV or PCV group.
• Intraoperative and postoperative blood gases, peak airway pressures, and clinical outcomes (ventilation duration, ICU stay, hospital stay) were recorded.

Main Results:

• PCV group demonstrated significantly higher PaO2 and lower dead space to tidal volume ratio compared to VCV after 60 minutes of OLV (P < 0.05).
• Peak inspiratory pressure (Ppeak) was higher in the VCV group (P < 0.05).
• PCV group showed improved postoperative oxygenation, reduced duration of mechanical ventilation, shorter ICU stays, and fewer hospital days.

Conclusions:

• PCV provides significant intraoperative and postoperative oxygenation advantages over VCV in elderly patients with poor pulmonary function during OLV.
• PCV may contribute to improved postoperative recovery in this patient population.