Korean J Anesthesiol.  2014 Oct;67(4):258-263. 10.4097/kjae.2014.67.4.258.

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

• Song SY
• Jung JY
• Cho MS
• Kim JH
• Ryu TH
• Kim BI

• KMID: 1937685
• DOI: http://doi.org/10.4097/kjae.2014.67.4.258

Abstract

BACKGROUND
The purpose of this study was to investigate the changes in airway pressure and arterial oxygenation between ventilation modes during one-lung ventilation (OLV) in patients undergoing thoracic surgery.
METHODS
We enrolled 27 patients for thoracic surgery with OLV in the lateral decubitus position. The subjects received various modes of ventilation in random sequences during surgery, including volume-controlled ventilation (VCV) and pressure-controlled ventilation-volume guaranteed (PCV-VG) with a tidal volume (TV) of 8 ml/kg of actual body weight. Target-controlled infusion (TCI) with propofol and remifentanil was used for anesthesia induction and maintenance. After double-lumen endobronchial tube (DLT) insertion, the proper positioning of the DLT was assessed using a fiberoptic bronchoscope. Peak inspiratory pressure (Ppeak), exhaled TV, and arterial blood gas were measured 30 min after each ventilation mode.
RESULTS
P(peak) was significantly reduced with the PCV-VG mode (19.6 +/- 2.5 cmH2O) compared with the VCV mode (23.2 +/- 3.1 cmH2O) (P < 0.000). However, no difference in arterial oxygen tension was noted between the groups (PCV-VG, 375.8 +/- 145.1 mmHg; VCV, 328.1 +/- 123.7 mmHg) (P = 0.063). The exhaled TV was also significantly increased in PCV-VG compared with VCV (451.4 +/- 85.4 vs. 443.9 +/- 85.9 ml; P = 0.035).
CONCLUSIONS
During OLV in patients with normal lung function, although PCV-VG did not provide significantly improved arterial oxygen tension compared with VCV, PCV-VG provided significantly attenuated airway pressure despite significantly increased exhaled TV compared with VCV.

Keyword

Airway pressure; Arterial oxygenation; One-lung ventilation; Pressure-controlled ventilation-volume guaranteed

MeSH Terms

Anesthesia
Body Weight
Bronchoscopes
Humans
Lung
One-Lung Ventilation*
Oxygen
Propofol
Thoracic Surgery
Tidal Volume
Ventilation
Oxygen
Propofol