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- W3021802021 abstract "We evaluated the effectiveness of pressure-controlled ventilation-volume guaranteed (PCV-VG) mode combined with open-lung approach (OLA) in patients during one-lung ventilation (OLV). First, 176 patients undergoing thoracoscopic surgery were allocated randomly to four groups: PCV+OLA (45 cases, PCV-VG mode plus OLA involving application of individualized positive end-expiratory pressure (PEEP) after a recruitment maneuver), PCV (44 cases, PCV-VG mode plus standard lung-protective ventilation with fixed PEEP of 5 cmH 2 O), VCV+OLA (45 cases, volume-controlled ventilation (VCV) plus OLA), and VCV (42 cases, VCV plus standard lung-protective ventilation). Mean airway pressure (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M1><mml:msub><mml:mrow><mml:mi>P</mml:mi></mml:mrow><mml:mrow><mml:mtext>mean</mml:mtext></mml:mrow></mml:msub></mml:math>), dynamic compliance (Cdyn), PaO 2 /FiO 2 ratio, intrapulmonary shunt ratio (Qs/Qt), dead space fraction (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M2><mml:msub><mml:mrow><mml:mi>V</mml:mi></mml:mrow><mml:mrow><mml:mtext>D</mml:mtext></mml:mrow></mml:msub><mml:mo>/</mml:mo><mml:msub><mml:mrow><mml:mi>V</mml:mi></mml:mrow><mml:mrow><mml:mtext>T</mml:mtext></mml:mrow></mml:msub></mml:math>), and plasma concentration of neutrophil elastase were obtained to assess the effects of four lung-protective ventilation strategies. At 45 min after OLV, the median (interquartile range (IQR))<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M3><mml:msub><mml:mrow><mml:mi>P</mml:mi></mml:mrow><mml:mrow><mml:mtext>mean</mml:mtext></mml:mrow></mml:msub></mml:math>was higher in the PCV+OLA group (13.00 (12.00, 13.00) cmH 2 O) and the VCV+OLA group (12.00 (12.00, 14.00) cmH 2 O) than in the PCV group (11.00 (10.00, 12.00) cmH 2 O) and the VCV group (11.00 (10.00, 12.00) cmH 2 O) (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M4><mml:mi>P</mml:mi><mml:mo><</mml:mo><mml:mn>0.05</mml:mn></mml:math>); the median (IQR) Cdyn was higher in the PCV+OLA group (27.00 (24.00, 32.00) mL/cmH 2 O) and the VCV+OLA group (27.00 (22.00, 30.00) mL/cmH 2 O) than in the PCV group (23.00 (21.00, 25.00) mL/cmH 2 O) and the VCV group (20.00 (18.75, 21.00) mL/cmH 2 O) (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M5><mml:mi>P</mml:mi><mml:mo><</mml:mo><mml:mn>0.05</mml:mn></mml:math>); the median (IQR) Qs/Qt in the PCV+OLA group (0.17 (0.16, 0.19)) was significantly lower than that in the PCV group (0.19 (0.18, 0.20)) and the VCV group (0.19 (0.17, 0.20)) (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M6><mml:mi>P</mml:mi><mml:mo><</mml:mo><mml:mn>0.05</mml:mn></mml:math>);<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M7><mml:msub><mml:mrow><mml:mi>V</mml:mi></mml:mrow><mml:mrow><mml:mtext>D</mml:mtext></mml:mrow></mml:msub><mml:mo>/</mml:mo><mml:msub><mml:mrow><mml:mi>V</mml:mi></mml:mrow><mml:mrow><mml:mtext>T</mml:mtext></mml:mrow></mml:msub></mml:math>was lower in the PCV+OLA group (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M8><mml:mn>0.18</mml:mn><mml:mo>±</mml:mo><mml:mn>0.05</mml:mn></mml:math>) and the VCV+OLA group (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M9><mml:mn>0.19</mml:mn><mml:mo>±</mml:mo><mml:mn>0.07</mml:mn></mml:math>) than in the PCV group (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M10><mml:mn>0.21</mml:mn><mml:mo>±</mml:mo><mml:mn>0.07</mml:mn></mml:math>) and the VCV group (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M11><mml:mn>0.22</mml:mn><mml:mo>±</mml:mo><mml:mn>0.06</mml:mn></mml:math>) (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M12><mml:mi>P</mml:mi><mml:mo><</mml:mo><mml:mn>0.05</mml:mn></mml:math>). The concentration of neutrophil elastase was lower in the PCV+OLA group than in the PCV, VCV+OLA, and VCV groups at total-lung ventilation 10 min after OLV (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M13><mml:mn>162.47</mml:mn><mml:mo>±</mml:mo><mml:mn>25.71</mml:mn></mml:math>,<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M14><mml:mn>198.58</mml:mn><mml:mo>±</mml:mo><mml:mn>41.99</mml:mn></mml:math>,<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M15><mml:mn>200.84</mml:mn><mml:mo>±</mml:mo><mml:mn>22.17</mml:mn></mml:math>, and<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M16><mml:mn>286.95</mml:mn><mml:mo>±</mml:mo><mml:mn>21.10</mml:mn><mml:mtext> </mml:mtext><mml:mtext>ng</mml:mtext><mml:mo>/</mml:mo><mml:mtext>mL</mml:mtext></mml:math>, resp.) (<mml:math xmlns:mml=http://www.w3.org/1998/Math/MathML id=M17><mml:mi>P</mml:mi><mml:mo><</mml:mo><mml:mn>0.05</mml:mn></mml:math>). In conclusion, PCV-VG mode combined with an OLA strategy leads to favorable effects upon lung mechanics, oxygenation parameters, and the inflammatory response during OLV." @default.
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- W3021802021 date "2020-04-29" @default.
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- W3021802021 title "Pressure-Controlled Ventilation-Volume Guaranteed Mode Combined with an Open-Lung Approach Improves Lung Mechanics, Oxygenation Parameters, and the Inflammatory Response during One-Lung Ventilation: A Randomized Controlled Trial" @default.
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- W3021802021 doi "https://doi.org/10.1155/2020/1403053" @default.
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