Publication:

Comparison of the effects of volume-controlled ventilation and pressure-controlled ventilation modes on hemodynamics, respiratory mechanics and blood gas parameters in patients undergoing laparoscopic cholecystectomy

Background This study aimed to compare the changes induced by VCV and PCV modes in hemodynamics, respiration (airway pressures, gas exchange parameters) and metabolism (acid-base balance) in patients undergoing laparoscopic cholecystectomy.

Methods Patients were divided into two randomised groups as volume-controlled ventilation (VCV) group (VC) and pressure-controlled ventilation (PCV) group (PC). The following parameters were recorded at 3 different time points: T1: in supine position 10 minutes after induction of anaesthesia, T2: 15 minutes after CO2 insufflation in inverted Trendelenburg position (head 30 degrees up), T3: 10 minutes after CO2 desufflation. HR, SpO2, SAP (systolic arterial pressure), DAP (diastolic arterial pressure), MAP (mean arterial pressure), PetCO2 (end-tidal carbon dioxide pressure), Ppeak, Pplateau, Pmean, Vt (tidal volume) and compliance with the available data, the cases in both groups Vd, Vd/Vt ratios and P(A-a)O2 were calculated. Arterial blood gas parameters (pH, PaO2, PaCO2, SaO2, P(a-et)CO2) values were recorded.

Results It was found that Ppeak and Pplateau values were significantly higher in the VC group (p<0.05). It was found that compliance was significantly higher in the PC group (p<0.05) (p<0.01). In the postoperative period, it was found that PaO2 values were significantly higher in the PC group compared to the VC group (p<0.05). It was found that the P(A-a)O2 values of the PC group were significantly higher than those of the VC group during the desufflation phase (p<0.05).

Conclusions We think that PCV mode can be a good alternative for the prevention and correction of physiopathological changes due to laparoscopic surgery.