[Comparison of pressure-controlled volume-guaranteed ventilation and volume-controlled ventilation in obese patients during gynecologic laparoscopic surgery in the Trendelenburg position].

Toker, MK ; Altıparmak, B ; et al.

In: Brazilian journal of anesthesiology (Elsevier), Jg. 69 (2019-11-01), Heft 6, S. 553-560

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Background and Objectives: The aim of this study was to investigate the efficacy of the pressure-controlled, volume-guaranteed (PCV-VG) and volume-controlled ventilation (VCV) modes for maintaining adequate airway pressures, lung compliance and oxygenation in obese patients undergoing laparoscopic hysterectomy in the Trendelenburg position.

Methods: Patients (104) who underwent laparoscopic gynecologic surgery with a body mass index between 30 and 40kg.m -2 were randomized to receive either VCV or PCV-VG ventilation. The tidal volume was set at 8mL.kg -1 , with an inspired oxygen concentration of 0.4 with a Positive End-Expiratory Pressure (PEEP) of 5mmHg. The peak inspiratory pressure, mean inspiratory pressure, plateau pressure, driving pressure, dynamic compliance, respiratory rate, exhaled tidal volume, etCO 2 , arterial blood gas analysis, heart rate and mean arterial pressure at 5minutes after induction of anesthesia in the and at 5, 30 and 60minutes, respectively, after pneumoperitoneum in the Trendelenburg position were recorded.

Results: The PCV-VG group had significantly decreased peak inspiratory pressure, mean inspiratory pressur, plateau pressure, driving pressure and increased dynamic compliance compared to the VCV group. Mean PaO 2 levels were significantly higher in the PCV-VG group than in the VCV group at every time point after pneumoperitoneum in the Trendelenburg position.

Conclusions: The PCV-VG mode of ventilation limited the peak inspiratory pressure, decreased the driving pressure and increased the dynamic compliance compared to VCV in obese patients undergoing laparoscopic hysterectomy. PCV-VG may be a preferable modality to prevent barotrauma during laparoscopic surgeries in obese patients.

Titel:	[Comparison of pressure-controlled volume-guaranteed ventilation and volume-controlled ventilation in obese patients during gynecologic laparoscopic surgery in the Trendelenburg position].
Autor/in / Beteiligte Person:	Toker, MK ; Altıparmak, B ; Uysal, Aİ ; Demirbilek, SG
Link:	Full Text Finder (Volltext)
Zeitschrift:	Brazilian journal of anesthesiology (Elsevier), Jg. 69 (2019-11-01), Heft 6, S. 553-560
Veröffentlichung:	Rio de Janeiro : Elsevier Editora Ltda, 2013-, 2019
Medientyp:	academicJournal
ISSN:	2352-2291 (electronic)
DOI:	10.1016/j.bjan.2019.09.003
Schlagwort:	Adult Female Humans Lung Compliance physiology Middle Aged Oxygen metabolism Positive-Pressure Respiration Prospective Studies Respiration, Artificial methods Tidal Volume physiology Gynecologic Surgical Procedures methods Head-Down Tilt Laparoscopy methods Obesity complications
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: Portuguese Transliterated Title: Comparação entre ventilação garantida por volume controlado por pressão e ventilação controlada por volume em pacientes obesos durante cirurgia laparoscópica ginecológica na posição de Trendelenburg. Publication Type: Comparative Study; Journal Article; Randomized Controlled Trial Language: Portuguese [Braz J Anesthesiol] 2019 Nov - Dec; Vol. 69 (6), pp. 553-560. <i>Date of Electronic Publication: </i>2019 Dec 10. MeSH Terms: Head-Down Tilt* ; Gynecologic Surgical Procedures / methods ; Laparoscopy / methods ; Obesity / *complications ; Adult ; Female ; Humans ; Lung Compliance / physiology ; Middle Aged ; Oxygen / metabolism ; Positive-Pressure Respiration ; Prospective Studies ; Respiration, Artificial / methods ; Tidal Volume / physiology References: Int J Clin Exp Med. 2014 Aug 15;7(8):2242-7. (PMID: 25232415) ; BMC Anesthesiol. 2015 May 06;15:56. (PMID: 25907273) ; JAMA. 2010 Mar 3;303(9):865-73. (PMID: 20197533) ; J Clin Anesth. 2016 Nov;34:55-61. (PMID: 27687346) ; Crit Care Med. 1992 Nov;20(11):1604-16. (PMID: 1424706) ; J Am Pharm Assoc (2003). 2014 Jan-Feb;54(1):e3. (PMID: 24898716) ; Crit Care. 2017 Aug 4;21(1):199. (PMID: 28774316) ; J Cardiothorac Vasc Anesth. 2017 Oct;31(5):1760-1766. (PMID: 28673814) ; J Thorac Dis. 2015 May;7(5):943-52. (PMID: 26101653) ; Best Pract Res Clin Anaesthesiol. 2015 Sep;29(3):285-99. (PMID: 26643095) ; Springerplus. 2016 Aug 03;5(1):1251. (PMID: 27536534) ; Br J Anaesth. 2012 Oct;109(4):493-502. (PMID: 22976857) ; Anesth Analg. 1995 May;80(5):961-6. (PMID: 7726439) ; Int J Clin Exp Med. 2014 Apr 15;7(4):1094-8. (PMID: 24955188) ; Obstet Gynecol. 2009 Nov;114(5):1041-1048. (PMID: 20168105) ; Ann Surg. 2005 Feb;241(2):219-26. (PMID: 15650630) ; Crit Care. 2017 Mar 21;21(1):63. (PMID: 28320439) ; Early Hum Dev. 2006 Dec;82(12):811-8. (PMID: 17069993) ; J Trauma. 1996 Nov;41(5):808-14. (PMID: 8913208) ; Springerplus. 2016 Oct 10;5(1):1761. (PMID: 27795903) ; Br J Anaesth. 2008 May;100(5):709-16. (PMID: 18407943) ; N Engl J Med. 2015 Feb 19;372(8):747-55. (PMID: 25693014) ; J Minim Invasive Gynecol. 2010 May-Jun;17(3):295-300. (PMID: 20303833) ; Korean J Anesthesiol. 2014 Oct;67(4):258-63. (PMID: 25368784) Contributed Indexing: Keywords: Anestesia geral; Complacência pulmonar; General anesthesia; Laparoscopia; Laparoscopy; Lung compliance; Mechanical ventilation; Obesidade; Obesity; Ventilação mecânica Substance Nomenclature: S88TT14065 (Oxygen) Entry Date(s): Date Created: 20191215 Date Completed: 20200724 Latest Revision: 20220822 Update Code: 20240513 PubMed Central ID: PMC9391862

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