Comparison of volume-controlled ventilation, pressure-controlled ventilation and pressure-controlled ventilation-volume guaranteed in infants and young children in the prone position : A prospective randomized study
Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved..
STUDY OBJECTIVE: To explore if the pressure-controlled ventilation (PCV) and pressure-controlled ventilation-volume guaranteed (PCV-VG) modes are superior to volume-controlled ventilation (VCV) in optimizing intraoperative respiratory mechanics in infants and young children in the prone position.
DESIGN: A single-center prospective randomized study.
SETTING: Children's Hospital, Zhejiang University School of Medicine.
PATIENTS: Pediatric patients aged 1 month to 3 years undergoing elective spinal cord detethering surgery.
INTERVENTIONS: Patients were randomly allocated to the VCV group, PCV group and PCV-VG group. The target tidal volume (VT) was 8 mL/kg and the respiratory rate (RR) was adjusted to maintain a constant end tidal CO2.
MEASUREMENTS: The primary outcome was intraoperative peak airway pressure (Ppeak). Secondary outcomes included other respiratory and ventilation variables, gas exchange values, serum lung injury biomarkers concentration, hemodynamic parameters and postoperative respiratory complications.
MAIN RESULTS: A total of 120 patients were included in the final analysis (40 in each group). The VCV group showed higher Ppeak at T2 (10 min after prone positioning) and T3 (30 min after prone positioning) than the PCV and PCV-VG groups (T2: P = 0.015 and P = 0.002, respectively; T3: P = 0.007 and P = 0.009, respectively). The prone-related decrease in dynamic compliance was prevented by PCV and PCV-VG ventilation modalities at T2 and T3 than by VCV (T2: P = 0.008 and P = 0.015, respectively; T3: P = 0.015 and P = 0.014, respectively). Additionally, there were no significant differences in other secondary outcomes among the three groups.
CONCLUSION: In infants and young children undergoing spinal cord detethering surgery in the prone position, PCV-VG may be a better ventilation mode due to its ability to mitigate the increase in Ppeak and decrease in Cdyn while maintaining consistent VT.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:95 |
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| Enthalten in: |
Journal of clinical anesthesia - 95(2024) vom: 06. Apr., Seite 111440 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bao, Chunying [VerfasserIn] |
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| Links: |
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| Themen: |
Comparative Study |
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| Anmerkungen: |
Date Completed 27.04.2024 Date Revised 27.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jclinane.2024.111440 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369501403 |
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| 100 | 1 | |a Bao, Chunying |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of volume-controlled ventilation, pressure-controlled ventilation and pressure-controlled ventilation-volume guaranteed in infants and young children in the prone position |b A prospective randomized study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 27.04.2024 | ||
| 500 | |a Date Revised 27.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a STUDY OBJECTIVE: To explore if the pressure-controlled ventilation (PCV) and pressure-controlled ventilation-volume guaranteed (PCV-VG) modes are superior to volume-controlled ventilation (VCV) in optimizing intraoperative respiratory mechanics in infants and young children in the prone position | ||
| 520 | |a DESIGN: A single-center prospective randomized study | ||
| 520 | |a SETTING: Children's Hospital, Zhejiang University School of Medicine | ||
| 520 | |a PATIENTS: Pediatric patients aged 1 month to 3 years undergoing elective spinal cord detethering surgery | ||
| 520 | |a INTERVENTIONS: Patients were randomly allocated to the VCV group, PCV group and PCV-VG group. The target tidal volume (VT) was 8 mL/kg and the respiratory rate (RR) was adjusted to maintain a constant end tidal CO2 | ||
| 520 | |a MEASUREMENTS: The primary outcome was intraoperative peak airway pressure (Ppeak). Secondary outcomes included other respiratory and ventilation variables, gas exchange values, serum lung injury biomarkers concentration, hemodynamic parameters and postoperative respiratory complications | ||
| 520 | |a MAIN RESULTS: A total of 120 patients were included in the final analysis (40 in each group). The VCV group showed higher Ppeak at T2 (10 min after prone positioning) and T3 (30 min after prone positioning) than the PCV and PCV-VG groups (T2: P = 0.015 and P = 0.002, respectively; T3: P = 0.007 and P = 0.009, respectively). The prone-related decrease in dynamic compliance was prevented by PCV and PCV-VG ventilation modalities at T2 and T3 than by VCV (T2: P = 0.008 and P = 0.015, respectively; T3: P = 0.015 and P = 0.014, respectively). Additionally, there were no significant differences in other secondary outcomes among the three groups | ||
| 520 | |a CONCLUSION: In infants and young children undergoing spinal cord detethering surgery in the prone position, PCV-VG may be a better ventilation mode due to its ability to mitigate the increase in Ppeak and decrease in Cdyn while maintaining consistent VT | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Mechanical ventilation mode | |
| 650 | 4 | |a Pediatrics | |
| 650 | 4 | |a Prone position | |
| 650 | 4 | |a Respiratory mechanics | |
| 650 | 4 | |a Spinal cord detethering surgery | |
| 700 | 1 | |a Cao, Hongmin |e verfasserin |4 aut | |
| 700 | 1 | |a Shen, Zhipeng |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Yaoqin |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Jinjin |e verfasserin |4 aut | |
| 700 | 1 | |a Shu, Qiang |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Qixing |e verfasserin |4 aut | |
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