Comparison of volume-controlled and pressure-controlled ventilation in steep Trendelenburg position for robot-assisted laparoscopic radical prostatectomy

Eun Mi Choi, Sungwon Na, Seung Ho Choi, Jiwon An, KoonHo Rha, Young Jun Oh

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Study Objective: To compare the effects of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) on respiratory mechanics and hemodynamics in steep Trendelenburg position. Design: Prospective, randomized clinical trial. Setting: University hospital. Patients: 34 ASA physical status 1 and 2 patients undergoing RLRP. Interventions: Patients were randomly allocated to either the VCV (n = 17) or the PCV group (n = 17). After induction of anesthesia, each patient's lungs were ventilated in constant-flow VCV mode with 50% O 2 and tidal volume of 8 mL/kg; a pulmonary artery catheter was then inserted. After establishment of 30° Trendelenburg position and pneumoperitoneum, VCV mode was switched to PCV mode in the PCV group. Measurements: Respiratory and hemodynamic variables were measured at baseline supine position (T1), post-Trendelenburg and pneumoperitoneum 60 minutes (T2) and 120 minutes (T3), and return to baseline after skin closure (T4). Main Results: The PCV group had lower peak airway pressure (AP peak ) and greater dynamic compliance (C dyn ) than the VCV group at T2 and T3 (P < 0.05). However, no other variables differed between the groups. Pulmonary arterial pressure and central venous pressure increased at T2 and T3 (P < 0.05). Cardiac output and right ventricular ejection fraction were unchanged in both groups. Conclusions: PCV offered greater C dyn and lower AP peak than VCV, but no advantages over VCV in respiratory mechanics or hemodynamics.

Original languageEnglish
Pages (from-to)183-188
Number of pages6
JournalJournal of Clinical Anesthesia
Volume23
Issue number3
DOIs
Publication statusPublished - 2011 May 1

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Head-Down Tilt
Prostatectomy
Ventilation
Pressure
Respiratory Mechanics
Pneumoperitoneum
Hemodynamics
Lung
Central Venous Pressure
Supine Position
Tidal Volume
Cardiac Output
Stroke Volume
Pulmonary Artery

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

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title = "Comparison of volume-controlled and pressure-controlled ventilation in steep Trendelenburg position for robot-assisted laparoscopic radical prostatectomy",
abstract = "Study Objective: To compare the effects of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) on respiratory mechanics and hemodynamics in steep Trendelenburg position. Design: Prospective, randomized clinical trial. Setting: University hospital. Patients: 34 ASA physical status 1 and 2 patients undergoing RLRP. Interventions: Patients were randomly allocated to either the VCV (n = 17) or the PCV group (n = 17). After induction of anesthesia, each patient's lungs were ventilated in constant-flow VCV mode with 50{\%} O 2 and tidal volume of 8 mL/kg; a pulmonary artery catheter was then inserted. After establishment of 30° Trendelenburg position and pneumoperitoneum, VCV mode was switched to PCV mode in the PCV group. Measurements: Respiratory and hemodynamic variables were measured at baseline supine position (T1), post-Trendelenburg and pneumoperitoneum 60 minutes (T2) and 120 minutes (T3), and return to baseline after skin closure (T4). Main Results: The PCV group had lower peak airway pressure (AP peak ) and greater dynamic compliance (C dyn ) than the VCV group at T2 and T3 (P < 0.05). However, no other variables differed between the groups. Pulmonary arterial pressure and central venous pressure increased at T2 and T3 (P < 0.05). Cardiac output and right ventricular ejection fraction were unchanged in both groups. Conclusions: PCV offered greater C dyn and lower AP peak than VCV, but no advantages over VCV in respiratory mechanics or hemodynamics.",
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Comparison of volume-controlled and pressure-controlled ventilation in steep Trendelenburg position for robot-assisted laparoscopic radical prostatectomy. / Choi, Eun Mi; Na, Sungwon; Choi, Seung Ho; An, Jiwon; Rha, KoonHo; Oh, Young Jun.

In: Journal of Clinical Anesthesia, Vol. 23, No. 3, 01.05.2011, p. 183-188.

Research output: Contribution to journalArticle

TY - JOUR

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AU - Choi, Eun Mi

AU - Na, Sungwon

AU - Choi, Seung Ho

AU - An, Jiwon

AU - Rha, KoonHo

AU - Oh, Young Jun

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N2 - Study Objective: To compare the effects of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) on respiratory mechanics and hemodynamics in steep Trendelenburg position. Design: Prospective, randomized clinical trial. Setting: University hospital. Patients: 34 ASA physical status 1 and 2 patients undergoing RLRP. Interventions: Patients were randomly allocated to either the VCV (n = 17) or the PCV group (n = 17). After induction of anesthesia, each patient's lungs were ventilated in constant-flow VCV mode with 50% O 2 and tidal volume of 8 mL/kg; a pulmonary artery catheter was then inserted. After establishment of 30° Trendelenburg position and pneumoperitoneum, VCV mode was switched to PCV mode in the PCV group. Measurements: Respiratory and hemodynamic variables were measured at baseline supine position (T1), post-Trendelenburg and pneumoperitoneum 60 minutes (T2) and 120 minutes (T3), and return to baseline after skin closure (T4). Main Results: The PCV group had lower peak airway pressure (AP peak ) and greater dynamic compliance (C dyn ) than the VCV group at T2 and T3 (P < 0.05). However, no other variables differed between the groups. Pulmonary arterial pressure and central venous pressure increased at T2 and T3 (P < 0.05). Cardiac output and right ventricular ejection fraction were unchanged in both groups. Conclusions: PCV offered greater C dyn and lower AP peak than VCV, but no advantages over VCV in respiratory mechanics or hemodynamics.

AB - Study Objective: To compare the effects of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) on respiratory mechanics and hemodynamics in steep Trendelenburg position. Design: Prospective, randomized clinical trial. Setting: University hospital. Patients: 34 ASA physical status 1 and 2 patients undergoing RLRP. Interventions: Patients were randomly allocated to either the VCV (n = 17) or the PCV group (n = 17). After induction of anesthesia, each patient's lungs were ventilated in constant-flow VCV mode with 50% O 2 and tidal volume of 8 mL/kg; a pulmonary artery catheter was then inserted. After establishment of 30° Trendelenburg position and pneumoperitoneum, VCV mode was switched to PCV mode in the PCV group. Measurements: Respiratory and hemodynamic variables were measured at baseline supine position (T1), post-Trendelenburg and pneumoperitoneum 60 minutes (T2) and 120 minutes (T3), and return to baseline after skin closure (T4). Main Results: The PCV group had lower peak airway pressure (AP peak ) and greater dynamic compliance (C dyn ) than the VCV group at T2 and T3 (P < 0.05). However, no other variables differed between the groups. Pulmonary arterial pressure and central venous pressure increased at T2 and T3 (P < 0.05). Cardiac output and right ventricular ejection fraction were unchanged in both groups. Conclusions: PCV offered greater C dyn and lower AP peak than VCV, but no advantages over VCV in respiratory mechanics or hemodynamics.

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