Hemodynamic and ventilatory effects of volume or pressure controlled ventilation in dogs submitted to pneumoperitoneum. Comparative study.
OBJECTIVE
Pressure controlled ventilation (PCV) is available in anesthesia machines, but there are no studies on its use during CO2 pneumoperitoneum (CPP). This study aimed at evaluating pressure-controlled ventilation and hemodynamic and ventilatory changes during CPP, as compared to conventional volume controlled ventilation (VCV).


METHODS
This study involved 16 dogs anesthetized with thiopental, fentanyl and pancuronium, which were randomly assigned to two groups: VC - volume controlled ventilation (n=8) and PC - pressure controlled ventilation (n=8). Hemodynamic and ventilatory parameters were monitored and recorded in 4 moments: M1 (before CPP), M2 (30 minutes after CPP = 10 mmHg), M3 (30 minutes after CPP=15 mmHg) and M4 (30 minutes after deflation).


RESULTS
With CPP, there has been significant increase in tidal volume in PC group; there has been increase in airway pressures (peak and plateau), decrease in compliance with increase in CPP pressure, increase in heart rate, maintenance of mean blood pressure with higher values in the VC group in all stages; there was also increase in right atrium pressure with significant decrease after deflation, decrease in arterial pH with minor variations in PC group, greater arterial pCO2 stability in PC group, and no significant changes in arterial pO2.


CONCLUSIONS
There were some differences in hemodynamic and ventilatory data between both ventilation control modes (VC and PC). It is possible to use pressure controlled ventilation during CPP, but the anesthesiologist must monitor and take a close look at alveolar ventilation, adjusting inspiratory pressure to ensure proper CO2 elimination and oxygenation.
Carraretto
Antonio Roberto
AR
Departamento de Anestesiologia da Faculdade de Medicina de Botucatu (FMB-UNESP), Botucatu. roberto@carraretto.med.br
Vianna
Pedro Thadeu Galvão
PT
de Almeida
Armando Vieira
AV
Ganem
Eliana Marisa
EM