Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for thoracic surgery.
BACKGROUND
Pressure-controlled ventilation (PCV) has been suggested as a tool to improve oxygenation during one-lung ventilation (OLV) for patients undergoing thoracic surgery. In this study we investigated whether PCV results in improved arterial oxygenation compared with volume-controlled ventilation (VCV) during OLV.


METHODS
Fifty-eight patients with good preoperative pulmonary function scheduled for thoracic surgery were prospectively randomized into two groups. Those in group A underwent OLV initially with VCV for 30 min followed by PCV for a similar period of time. Those in group B underwent OLV initially with PCV for 30 min followed by VCV for a similar duration. Airway pressures and arterial blood gases were obtained during OLV at the end of each ventilatory mode.


RESULTS
There were no differences during OLV in arterial oxygenation between VCV (Pao2, 206.1 +/- 62.4 mm Hg) and PCV (Pao2, 202.1 +/- 56.4 mm Hg; P = 0.534). Peak airway pressure was lower with PCV than with VCV (24.43 +/- 3.42 cm H2O vs. 34.16 +/- 5.21 cm H2O; P < 0.001).


CONCLUSIONS
The use of PCV during OLV does not lead to improved oxygenation during OLV compared with VCV for patients with good preoperative pulmonary function, but PCV did lead to lower peak airway pressures. Further study is needed for patients with severe obstructive or restrictive pulmonary disease.
Unzueta
M Carmen
MC
Department of Anesthesiology, Hospital de Sant Pau, Barcelona, Spain. mcunzueta@telefonica.ne
Casas
J Ignacio
JI
Moral
M Victoria
MV
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008168:Lung / Q000502:physiology*; D008176:Lung Volume Measurements / Q000379:methods; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012121:Respiration, Artificial / Q000379:methods*; D019616:Thoracic Surgical Procedures / Q000379:methods*