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Impact of pressure -regulated volume control vs volume -controlled ventilation on respiratory mechanics in pediatric

Jing Shi1, Wenjuan Bao1, Wenjing Chen1

  • 1Department of Anesthesiology, Hebei Clinical Research Center for Children's Health and Diseases, Hebei Children's Hospital, Shijiazhuang Hebei, China.

Wideochirurgia I Inne Techniki Maloinwazyjne = Videosurgery and Other Miniinvasive Techniques
|August 22, 2026
PubMed

Insights

Pressure-regulated volume control (PRVC) ventilation lowered peak and mean airway pressures in young children during laparoscopic surgery compared to volume-controlled ventilation (VCV). However, plateau and driving pressures were similar, indicating comparable alveolar distention between the two ventilation modes.

Area of Science:

  • Pediatric Anesthesiology
  • Respiratory Mechanics
  • Mechanical Ventilation

Background:

  • Pneumoperitoneum during pediatric laparoscopic surgery can negatively impact respiratory mechanics and increase the risk of ventilator-induced lung injury.
  • Optimal mechanical ventilation strategies in this setting remain a subject of debate.

Purpose of the Study:

  • To compare the efficacy of pressure-regulated volume control (PRVC) versus volume-controlled ventilation (VCV) in young children undergoing laparoscopic surgery.
  • To assess the impact of these ventilation modes on airway pressures and gas exchange.

Main Methods:

  • A randomized controlled trial involving 120 children aged 1-3 years undergoing prolonged laparoscopic surgery (≥120 min).
  • Patients were assigned to either PRVC or VCV group.
  • Primary outcome was peak inspiratory pressure (Ppeak) at 30 minutes post-pneumoperitoneum; secondary outcomes included other airway pressures, gas exchange, hemodynamics, and complication rates.

Main Results:

  • PRVC resulted in significantly lower Ppeak and mean airway pressure (Pmean) compared to VCV at 30 minutes post-pneumoperitoneum.
  • No significant differences were observed in plateau pressure (Pplat) or driving pressure (ΔP) between the groups.
  • The arterial-to-end-tidal CO2 gradient was wider with PRVC, though hemodynamic variables and complication rates were similar between modes.

Conclusions:

  • PRVC ventilation reduces peak and mean airway pressures in pediatric laparoscopic surgery but does not alter plateau or driving pressures, suggesting similar alveolar distention compared to VCV.
  • Both ventilation modes provide adequate gas exchange and hemodynamic stability.
  • While PRVC may offer benefits in airway pressure management, its routine adoption over VCV should not solely depend on Ppeak reduction.
Abstract

Keywords:
carbon dioxide monitoringlaparoscopic surgerypediatric anesthesiapressure -regulated volume controlvolume -controlled ventilation

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