Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynecologic surgery in the Trendelenburg position.
Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynecologic surgery in the Trendelenburg position.
复制标题
DOI：
10.7150/ijms.49253
复制
发表时间：
2020
影响因子：
3.6
通讯作者：
Park EY
中科院分区：
文献类型：
--
作者：
Lee JM;Lee SK;Rhim CC;Seo KH;Han M;Kim SY;Park EY
背景：压力控制通气容量保证（PCV-VG）越来越多地用于全身麻醉期间的通气。在机器人辅助腹腔镜妇科手术中，通常采用头低脚高位二氧化碳（CO2）气腹。在此，我们假设与容量控制通气（VCV）和压力控制通气（PCV）相比，PCV-VG会降低吸气峰压（Ppeak）。方法：共有60例患者入组本研究，并随机分配接受VCV、PCV或PCV-VG。在麻醉诱导后15分钟（T0）、CO2气腹和Trendelenburg体位后30和60分钟（分别为T1和T2）以及麻醉结束时仰卧位放置后15分钟（T3），测量仰卧位的血流动力学变量、呼吸变量和动脉血气。结果：VCV组的Ppeak高于PCV和PCV-VG组（p=0.011）。PCV和PCV-VG组的平均吸气压（Pmean）高于VCV组（p<0.001）。VCV组的动态肺顺应性（Cdyn）低于PCV和PCV-VG组（p=0.001）。结论：与VCV相比，PCV和PCV-VG提供了更低的Ppeak，更高的Pmean，并改善了Cdyn，在机器人辅助腹腔镜妇科手术中采用Trendelenburg体位时，血流动力学变量或动脉血气结果无显著差异。
Background: Pressure-controlled ventilation volume-guaranteed (PCV-VG) is being increasingly used for ventilation during general anesthesia. Carbon dioxide (CO2) pneumoperitoneum in the Trendelenburg position is routinely used during robot-assisted laparoscopic gynecologic surgery. Here, we hypothesized that PCV-VG would reduce peak inspiratory pressure (Ppeak), compared to volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV). Methods: In total, 60 patients were enrolled in this study and randomly assigned to receive VCV, PCV, or PCV-VG. Hemodynamic variables, respiratory variables, and arterial blood gases were measured in the supine position 15 minutes after the induction of anesthesia (T0), 30 and 60 minutes after CO2 pneumoperitoneum and Trendelenburg positioning (T1 and T2, respectively), and 15 minutes after placement in the supine position at the end of anesthesia (T3). Results: The Ppeak was higher in the VCV group than in the PCV and PCV-VG groups (p=0.011). Mean inspiratory pressure (Pmean) was higher in the PCV and PCV-VG groups than in the VCV group (p<0.001). Dynamic lung compliance (Cdyn) was lower in the VCV group than in the PCV and PCV-VG groups (p=0.001). Conclusion: Compared to VCV, PCV and PCV-VG provided lower Ppeak, higher Pmean, and improved Cdyn, without significant differences in hemodynamic variables or arterial blood gas results during robot-assisted laparoscopic gynecologic surgery with Trendelenburg position.
登录
查看更多内容
影响因子：
9.8
作者：
Kalmar, A. F.;Foubert, L.;Struys, M. M. R. F.
通讯作者：
Struys, M. M. R. F.
DOI：
10.4103/aer.aer_82_19
发表时间：
2019-04-01
期刊：
Anesthesia, essays and researches
影响因子：
--
作者：
Gad, Mona;Gaballa, Khaled;Nabil, Hanan
通讯作者：
Nabil, Hanan
影响因子：
8.8
作者：
MARINI, JJ;RAVENSCRAFT, SA
通讯作者：
RAVENSCRAFT, SA
影响因子：
2.5
作者：
Keszler, Martin
通讯作者：
Keszler, Martin
影响因子：
1.5
作者：
Phong, S. V. N.;Koh, L. K. D.
通讯作者：
Koh, L. K. D.