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Effects of pressure-controlled ventilation-volume guaranteed on children undergoing thoracic surgery: a prospective,

Lei Wang1, Yi Zhu1, Shili Zhu1

  • 1Department of Anesthesiology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.

Frontiers in Medicine
|October 1, 2025
PubMed

Insights

Pressure-controlled ventilation-volume guaranteed (PCV-VG) significantly improves outcomes in pediatric thoracic surgery. This ventilation mode reduces intrapulmonary shunt and postoperative complications during one-lung ventilation (OLV).

Area of Science:

  • Pediatric Anesthesiology
  • Thoracic Surgery
  • Mechanical Ventilation

Background:

  • Pediatric thoracic surgery with one-lung ventilation (OLV) is associated with higher morbidity and mortality compared to adults.
  • Appropriate mechanical ventilation modes may reduce these adverse outcomes.
  • This study investigates the efficacy of pressure-controlled ventilation-volume guaranteed (PCV-VG) in pediatric patients undergoing thoracic surgery.

Purpose of the Study:

  • To evaluate if PCV-VG reduces intrapulmonary shunt (Qs/Qt) in pediatric patients during OLV.
  • To assess the impact of PCV-VG on ventilator-induced lung injury (VILI).
  • To compare PCV-VG with volume-controlled ventilation (VCV) in terms of respiratory parameters and postoperative complications.

Main Methods:

  • Eighty children undergoing thoracic surgery requiring OLV were randomized into PCV-VG and VCV groups.
  • The primary outcome was the Qs/Qt fraction during OLV.
  • Secondary outcomes included respiratory parameters, blood gas analysis, and postoperative pulmonary complications (PPCs).

Main Results:

  • PCV-VG significantly improved Qs/Qt during OLV (p < 0.0001).
  • PCV-VG enhanced oxygenation, reduced airway pressure (p < 0.0001), and lowered the incidence of PPCs (p = 0.001) compared to VCV.
  • The duration of postoperative mechanical ventilation was also shortened with PCV-VG (p = 0.036).

Conclusions:

  • PCV-VG implementation in pediatric thoracic surgery offers significant benefits.
  • PCV-VG improves Qs/Qt, oxygenation, and reduces airway pressure during OLV.
  • This ventilation strategy effectively alleviates VILI and reduces postoperative complications in pediatric patients.
Abstract

Keywords:
childrenintrapulmonary shuntone-lung ventilationpressure-controlled ventilation-volume guaranteedventilator-induced lung injuryvideo-assisted thoracoscopic surgery

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