Effects of Pressure Control Ventilation-volume Guaranteed for Patients undergoing Da Vinci Robotic-assisted Pulmonary Lobotomy: A Randomized Controlled Trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LILin ¹ , ZHANGYi-nan ¹ , XUShi-guang ² , WANGShu-min ² ,  DIAOYu-gang ¹ , ZHANGTie-zheng ¹

1. Department of Anaesthesiology, The General Hospital of Shenyang Military Region, Shenyang 110016, P. R. China;
2. Department of Thoracic Surgery, The General Hospital of Shenyang Military Region, Shenyang 110016, P. R. China;

Corresponding author：

DIAOYu-gang, Email: Diao72@163.com

Keywords：

Pressure control ventilation-volume guaranteed; Volume control ventilation; Da Vinci robotic; Pulmonary lobotomy

DOI：

10.7507/1007-4848.20150231

Video：

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Objective To investigate the effect of pressure control ventilation-volume guaranteed (PCV-VG) for patients undergoing da Vinci robotic-assisted pulmonary lobotomy. Method A total of 40 patients undergoing Da Vinci robotic-assisted pulmonary lobotomy were randomly divided into two groups:a PCV-VG group (G group) and a volume-controlled ventilation (VCV) group (V group). There were 20 patients in each group with 13 males and 7 females at age of 49.0±5.5 years in the G group, 16 males and 4 females at age of 51.0±3.9 years in the V group. Haemodynamics indexes and oxygenation parameters were recorded at different times and compared between the two groups. Results During one-lung ventilation (OLV) period, the peak inspiratory pressure (P_peak), respiratory index (RI) and arterial partial pressure of carbon dioxide (PaCO2) in the G group were statistically lower than those in the V group (P<0.05). While the Cdyn and inspired oxygen fraction(OI) were higher in the G group than those in the V group (P<0.05). Conclusion Compared with the traditional VCV ventilation mode, the PCV-VG ventilation mode improves P_peak, Cdyn, OI, and RI of the patients undergoing da Vinci robotic-assisted pulmonary lobotomy.

Citation： LILin, ZHANGYi-nan, XUShi-guang, WANGShu-min, DIAOYu-gang, ZHANGTie-zheng. Effects of Pressure Control Ventilation-volume Guaranteed for Patients undergoing Da Vinci Robotic-assisted Pulmonary Lobotomy: A Randomized Controlled Trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(10): 923-927. doi: 10.7507/1007-4848.20150231 Copy

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18.	Senturk NM,Dilek A,Camci E,et al.Effects of positive endexpiratory pressure on ventilatory and oxygenation parameters during pressure-controlled one-lung ventilation.J Cardiothorac Vasc Anesth,2005,19(1):71-75.
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21.	Hoftman N,Canales C,Leduc M,et al.Positive end expiratory pressure during one-lung ventilation:selecting ideal patients and ventilator settings with the aim of improving arterial oxygenation.Ann Card Anaesth,2011,14(3):183-187.
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1. Brad S,Ralph L.Advancements in robotic-assisted thoracic surgery.Anesthesiology Clin,2012,30(4):699-708.
2. Grichnik KP,Clark JA.Pathophysiology and management of onelung ventilation.Thorac Surg Clin,2005,15(5):85-103.
3. Szegedi LL.Pathophysiology of one-lung ventilation.Anesthesiol Clin North America,2001,19(3):435-453.
4. Cohen E.Management of one-lung ventilation.Anesthesiol Clin North America,2001,19(3):475-495.
5. Cerfolio RJ,Bryant AS,Minnich DJ.Starting a robotic program in general thoracic surgery:why,how,and lessons learned.Ann Thorac Surg,2011,91(6):1729-1737.
6. Nagendran J,Stewart K,Hoskinson M,et al.An anesthesiologist's guide to hypoxic pulmonary vasoconstriction:implications for managing single-lung anesthesia and atelectasis.Curr Opin Anaesthesiol,2006,19(4):34-43.
7. Lohser J.Evidence-based management of one-lung ventilation.Anesthesiology Clin,2008,26(6):241-272.
8. McMullen MC,Girling LG,Graham MR,et al.Biologically variable ventilation improves oxygenation and respiratory mechanics during one-lung ventilation.Anesthesiology,2006,105(9):91-97.
9. Lee SM,Kim WH,Ahn HJ,et al.The effects of prolonged inspiratory time during one-lung ventilation:a randomised controlled trial.Anaesthesia,2013,68(4):908-916.
10. Fischer GW,Cohen E.An update on anesthesia for thoracoscopic surgery.Curr Opin Anaesthesiol,2010,23(1):7-11.
11. Misiolek H,Knapik P,Swanevelder J,et al.Comparison of doublelung jet ventilation and one-lung ventilation for thoracotomy.Eur J Anaesthesiol,2008,25(4):15-21.
12. Dulu A,Pastores SM,Park B,et al.Prevalence and mortality of acute lung injury and ARDS after lung resection.Chest,2006,130(11):73-78.
13. De Conno E,Steurer MP,Wittlinger M,et al.Anesthetic-induced improvement of the inflammatory response to one-lung ventilation.Anesthesiology,2009,110(3):1316-1326.
14. Unzueta MC,Casas JI,Moral MV.Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for thoracic surgery.Anesth Analg,2007,104(11):1029-1033.
15. Ishikawa S,Lohser J.One-lung ventilation and arterial oxygenation.Curr Opin Anaesthesiol,2011,24(1):S24-31.
16. Senturk M.New concepts of the management of one-lung ventilation.Curr Opin Anaesthesiol,2006,19(1):1-4.
17. Kim SH,Jung KT,An TH.Effects of tidal volume and PEEP on arterial blood gases and pulmonary mechanics during one-lung ventilation.J Anesth,2012,26(4):568-573.
18. Senturk NM,Dilek A,Camci E,et al.Effects of positive endexpiratory pressure on ventilatory and oxygenation parameters during pressure-controlled one-lung ventilation.J Cardiothorac Vasc Anesth,2005,19(1):71-75.
19. Santa CR,Rojas JI,Nervi R,et al.High versus low positive endexpiratory pressure(PEEP)levels for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome.Cochrane Database Syst Rev,2013,6(1):CD009098.
20. Li HB,Zhang Y,Gao BB,et al.Effects of positive end expiratory pressure on pulmonary surfactant in patients undergoing one-lung ventilation.Chin Med J,2010,90(25):1767-1769.
21. Hoftman N,Canales C,Leduc M,et al.Positive end expiratory pressure during one-lung ventilation:selecting ideal patients and ventilator settings with the aim of improving arterial oxygenation.Ann Card Anaesth,2011,14(3):183-187.
22. Kallet RH,Campbell AR,Dicker RA,et a1.Work of breathing during lung protective ventilation in patients with acute lung injury and acute respiratory distress syndrome:A comparison between volume and pressure-regulated breathing modes.Respir Care,2005,50(5):1623-1631.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effects of Pressure Control Ventilation-volume Guaranteed for Patients undergoing Da Vinci Robotic-assisted Pulmonary Lobotomy: A Randomized Controlled Trial

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