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KMID : 0356920140670040258
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Korean Journal of Anesthesiology
2014 Volume.67 No. 4 p.258 ~ p.263
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Volume-controlled versus pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation
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Song Seok-Young
Jung Jin-Yong
Cho Min-Su
Kim Jong-Hae
Ryu Tae-Ha
Kim Bong-Il
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Abstract
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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: Ppeak 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.
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KEYWORD
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Airway pressure, Arterial oxygenation, One-lung ventilation, Pressure-controlled ventilation-volume guaranteed
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