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

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Respiratory Physiology

Background:

• One-lung ventilation (OLV) is crucial for thoracic surgery but can lead to respiratory complications.
• Optimizing ventilation strategies during OLV is essential for patient safety and outcomes.

Purpose of the Study:

• To compare airway pressure and arterial oxygenation between volume-controlled ventilation (VCV) and pressure-controlled ventilation-volume guaranteed (PCV-VG) during OLV.
• To evaluate the efficacy of PCV-VG in patients undergoing thoracic surgery.

Main Methods:

• 27 patients undergoing thoracic surgery with OLV were randomized to VCV or PCV-VG.
• Ventilation parameters including peak inspiratory pressure (Ppeak), exhaled tidal volume (TV), and arterial blood gases were measured.
• Anesthesia was maintained using target-controlled infusion (TCI) with propofol and remifentanil.

Main Results:

• PCV-VG significantly reduced Ppeak compared to VCV (19.6 vs. 23.2 cmH2O).
• Exhaled TV was significantly increased with PCV-VG compared to VCV (451.4 vs. 443.9 ml).
• No significant difference in arterial oxygen tension was observed between the ventilation modes.

Conclusions:

• PCV-VG attenuates airway pressure during OLV in patients with normal lung function.
• PCV-VG offers a potentially safer ventilation strategy by reducing peak airway pressures.
• Further research may explore optimizing PCV-VG settings for improved oxygenation during OLV.