Comparison of pressure control ventilation with volume control ventilation in patients undergoing spine surgery in prone position: An open label randomized controlled trial
Introduction: Evaluation and comparison of two modes of mechanical ventilation – volume control and pressure control in spine surgery in prone position in terms of respiratory mechanics (peak airway pressure [PAP], plateau pressure, lung compliance, dead space and oxygenation), hemodynamic parameter...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | The Indian Anaesthetists' Forum |
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| Online Access: | https://journals.lww.com/10.4103/TheIAForum.TheIAForum_15_25 |
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| author | Poonam Godhwal Renu Bala Lalit Takia Raj Singh |
| author_facet | Poonam Godhwal Renu Bala Lalit Takia Raj Singh |
| author_sort | Poonam Godhwal |
| collection | DOAJ |
| description | Introduction:
Evaluation and comparison of two modes of mechanical ventilation – volume control and pressure control in spine surgery in prone position in terms of respiratory mechanics (peak airway pressure [PAP], plateau pressure, lung compliance, dead space and oxygenation), hemodynamic parameters (heart rate and blood pressure), pulmonary function tests (vital capacity, peak expiratory flow rate, forced expiratory volume in first second).
Materials and Methods:
After obtaining approval from institutional ethics committee, the present prospective, randomized, single-blind study was conducted in 50 adult patients of either sex, American Society of Anesthesiologists I or II undergoing thoracic or lumbar spine surgery in prone position. Standard anesthesia protocols comprising of thiopentone, fentanyl and vecuronium were followed. Patients in volume control ventilation (VCV) group (n = 25) were ventilated with volume control mode with tidal volume (TV) = 7 ml/kg, positive end expiratory pressure = 5 cm H2O, I:E = 1:2 and respiratory rate varied to keep Et CO2 = 35–40 mmHg, FiO2 = 0.4. While in pressure controlled ventilation (PCV) mode (n = 25) patients were ventilated with similar settings except peak inspiratory pressure was adjusted to determine TV = 7 ml/kg. Pulmonary function tests were measured pre-operatively and post-operatively. Respiratory mechanics (PAP, lung compliance) and hemodynamic parameters were measured pre-, intra-, and post-operatively.
Results:
The demographic profile and surgical characteristics were similar between the groups. Peak inspiratory pressure was higher in VCV (20 vs. 18) and dynamic compliance low in VCV (31.3 vs. 35.93). Other parameters like dead space, minute ventilation, EtCO2 and oxygenation were comparable in the two groups. Postoperative PFT decreased in both groups but were comparable.
Conclusion:
This study found that intraoperative respiratory mechanisms were better maintained with PCV mode than VCV in patients undergoing thoracolumbar spine surgery in prone position although both offered similar pulmonary functions. Therefore, pressure mode can be a better alternative for ventilator strategy. |
| format | Article |
| id | doaj-art-ef5fb9dfb4204b758e14775bcc1ed064 |
| institution | DOAJ |
| issn | 0973-0311 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Indian Anaesthetists' Forum |
| spelling | doaj-art-ef5fb9dfb4204b758e14775bcc1ed0642025-08-20T03:16:11ZengWolters Kluwer Medknow PublicationsThe Indian Anaesthetists' Forum0973-03112025-01-01261616810.4103/TheIAForum.TheIAForum_15_25Comparison of pressure control ventilation with volume control ventilation in patients undergoing spine surgery in prone position: An open label randomized controlled trialPoonam GodhwalRenu BalaLalit TakiaRaj SinghIntroduction: Evaluation and comparison of two modes of mechanical ventilation – volume control and pressure control in spine surgery in prone position in terms of respiratory mechanics (peak airway pressure [PAP], plateau pressure, lung compliance, dead space and oxygenation), hemodynamic parameters (heart rate and blood pressure), pulmonary function tests (vital capacity, peak expiratory flow rate, forced expiratory volume in first second). Materials and Methods: After obtaining approval from institutional ethics committee, the present prospective, randomized, single-blind study was conducted in 50 adult patients of either sex, American Society of Anesthesiologists I or II undergoing thoracic or lumbar spine surgery in prone position. Standard anesthesia protocols comprising of thiopentone, fentanyl and vecuronium were followed. Patients in volume control ventilation (VCV) group (n = 25) were ventilated with volume control mode with tidal volume (TV) = 7 ml/kg, positive end expiratory pressure = 5 cm H2O, I:E = 1:2 and respiratory rate varied to keep Et CO2 = 35–40 mmHg, FiO2 = 0.4. While in pressure controlled ventilation (PCV) mode (n = 25) patients were ventilated with similar settings except peak inspiratory pressure was adjusted to determine TV = 7 ml/kg. Pulmonary function tests were measured pre-operatively and post-operatively. Respiratory mechanics (PAP, lung compliance) and hemodynamic parameters were measured pre-, intra-, and post-operatively. Results: The demographic profile and surgical characteristics were similar between the groups. Peak inspiratory pressure was higher in VCV (20 vs. 18) and dynamic compliance low in VCV (31.3 vs. 35.93). Other parameters like dead space, minute ventilation, EtCO2 and oxygenation were comparable in the two groups. Postoperative PFT decreased in both groups but were comparable. Conclusion: This study found that intraoperative respiratory mechanisms were better maintained with PCV mode than VCV in patients undergoing thoracolumbar spine surgery in prone position although both offered similar pulmonary functions. Therefore, pressure mode can be a better alternative for ventilator strategy.https://journals.lww.com/10.4103/TheIAForum.TheIAForum_15_25mechanical ventilationpulmonary function testrespiratory mechanicsspine surgeryventilator modes |
| spellingShingle | Poonam Godhwal Renu Bala Lalit Takia Raj Singh Comparison of pressure control ventilation with volume control ventilation in patients undergoing spine surgery in prone position: An open label randomized controlled trial The Indian Anaesthetists' Forum mechanical ventilation pulmonary function test respiratory mechanics spine surgery ventilator modes |
| title | Comparison of pressure control ventilation with volume control ventilation in patients undergoing spine surgery in prone position: An open label randomized controlled trial |
| title_full | Comparison of pressure control ventilation with volume control ventilation in patients undergoing spine surgery in prone position: An open label randomized controlled trial |
| title_fullStr | Comparison of pressure control ventilation with volume control ventilation in patients undergoing spine surgery in prone position: An open label randomized controlled trial |
| title_full_unstemmed | Comparison of pressure control ventilation with volume control ventilation in patients undergoing spine surgery in prone position: An open label randomized controlled trial |
| title_short | Comparison of pressure control ventilation with volume control ventilation in patients undergoing spine surgery in prone position: An open label randomized controlled trial |
| title_sort | comparison of pressure control ventilation with volume control ventilation in patients undergoing spine surgery in prone position an open label randomized controlled trial |
| topic | mechanical ventilation pulmonary function test respiratory mechanics spine surgery ventilator modes |
| url | https://journals.lww.com/10.4103/TheIAForum.TheIAForum_15_25 |
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