Impact of Pressure Control Ventilation and Volume Control Ventilation on oxygenation, pulmonary mechanics and haemodynamics during One Lung Ventilation in patients undergoing thoracic surgery: Arandomised controlled crossover study

Abstract

Backgroud: Anaesthesia for thoracic surgery is nowadays performed with one lung ventilation (OLV) using volume control ventilation (VCV). Mechanical characteristics of pressure control ventilation (PCV) are thought to allow more homogenous distribution and improve oxygenation and reduce airway pressure so decrease chances of airway trauma and acute lung injury (ALI). This study was aimed to evaluate impact of two lung ventilation strategy (PCV/VCV) on oxygenation, pulmonary mechanics and haemodynamics during one lung ventilation in patient undergoing thoracic surgery.Method: After institutional ethical committee clearance this randomised single blind crossover study includes 30 patients of ASA I,II,III for elective thoracic surgery, using OLV and minimum duration of surgery of one hour were included in this study. Divided in two groups A and B using VCV first then PCV and vice versa. Haemodynamic parameters, ABG analysis and respiratory parameters were recorded, data collected and analysed by IBM SPSS statistics version 20.Results: Demographic, haemodynamic and ABG parameters were comparable in both groups higher Ppeak during VCV than PCV (p=0.004). Ppeak during OLV with VCV was significantly higher than during two lung ventilation (TLV) before starting OLV and end of the study (p<0.05). Higher dynamic compliance in OLV – PCV group than OLV – VCV group (p<0.001). Conclusion: PCV s a better ventilation mode than VCV in OLV with respect to reducing the incidence of barotrauma and ALI in patient undergoing elective thoracic surgery. Both modes are equivalent with respect to arterial oxygenation.