Applications of pressure control ventilation volume guaranteed during one-lung ventilation in thoracic surgery

Abstract

Objective: To explore the effects of ventilatory mode "pressure controlled ventilation-volume guaranteed" (PCV-VG) on the inspiratory pressures, oxygenation parameters and hemodynamics of patients during one lung ventilation (OLV) for thoracic surgery, compared with volume controlled ventilation (VCV).

Methods: Twenty participants were recruited and equally assigned into two groups in a controlled, randomized, crossover design. Group A: VCV was performed initially and changed into PCV-VG after 30 min; Group B: In the reverse order. Blood gas analysis, peak inspiratory pressure (Ppeak), mean inspiratory pressure (Pmean), plateau inspiratory pressure (Plateau) were measured at four different time points: (1) 30 min after total lung ventilation (TLV); (2) 30 min after one lung ventilation (VCV or PCV-VG); (3) 30 min after shifting to the other ventilatory mode, and (4) 30 min after reconstruction of TLV.

Results: The Ppeak, Plateau, and Pmean were significantly lower in PCV-VG compared with VCV. There was significant increase in arterial partial pressure of oxygen under PCV-VG.

Conclusion: In patients undergoing thoracic surgery with OLV, pressure controlled volume guaranteed mode of ventilation may have better effects by decreasing inspiratory pressure parameters and improving arterial oxygenation than volume controlled ventilation.

Keywords: One lung ventilation; arterial oxygenation; inspiratory pressure parameters; pressure controlled ventilation-volume guaranteed; volume controlled ventilation.