Related Experiment Video
Updated: May 24, 2025
Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics
Published on: April 19, 2024
Flow-controlled versus pressure-controlled ventilation in thoracic surgery with one-lung ventilation - A randomized
Julia Abram1, Patrick Spraider1, Judith Martini1
1Department of Anesthesia and Intensive Care Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
Study Objective:
Comparison of flow-controlled ventilation (FCV) to standard of pressure-controlled ventilation (PCV) in thoracic surgery procedures requiring one-lung ventilation.
Design:
Prospective, non-blinded, randomized, controlled trial.
Setting:
Operating theater at a university hospital, Austria.
Patients:
Patients scheduled for elective, thoracic surgery.
Interventions:
Participants received ventilation randomly either with FCV or PCV per-protocol for the duration of anesthesia.
Measurements:
The primary endpoint was oxygenation assessed by paO2 / FiO2 ratio 30 min after the start of OLV. Secondary endpoints included the required minute volume for CO2 removal, applied mechanical power and incidence of postoperative pulmonary complications.
Main Results:
A total of 46 patients were enrolled and 43 included in the primary analysis. The primary endpoint paO2 / FiO2 ratio was significantly higher in the FCV group (n = 21) compared to the control group (PCV n = 22) (187 vs 136 mmHg, MD 39 (95 % CI 1 to 75); p = 0.047). The required respiratory minute volume to obtain comparable mild hypercapnia during OLV was significantly lower in FCV (3.0 vs 4.5 l/min, MD -1.3 (95 % CI -1.9 to -0.8); p < 0.001). The applied mechanical power was also significantly lower (3.5 versus 7.6 J/min, MD -3.8 (95 % CI -5.3 to -2.7); p < 0.001).
Conclusions:
In this single-center randomized controlled trial, flow-controlled ventilation improved gas exchange parameters in terms of oxygenation and carbon dioxide removal during one-lung ventilation in patients undergoing thoracic surgery and reduced the mechanical impact of artificial ventilation.
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