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Pressure-controlled versus volume-controlled ventilation during one-lung ventilation in the prone position for robot-assisted esophagectomy

Authors
 Yong Seon Choi  ;  Jae Kwang Shim  ;  Sungwon Na  ;  Seung Bum Hong  ;  Yong Woo Hong  ;  Young Jun Oh 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.23(10) : 2286-2291, 2009 
Journal Title
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 
ISSN
 0930-2794 
Issue Date
2009
MeSH
Analysis of Variance ; Esophagectomy/methods* ; Esophagoscopy/methods* ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Pressure ; Prone Position ; Prospective Studies ; Respiration, Artificial/methods* ; Respiratory Function Tests ; Robotics*
Keywords
Minimally invasive esophagectomy ; One-lung ventilation ; Oxygenation ; Prone position ; Pressure-controlled ventilation ; Volume-controlled ventilation
Abstract
BACKGROUND: The prone position during robotic esophageal mobilization for minimally invasive esophagectomy (MIE) provides several advantages with regards to operative times, surgeon ergonomics, and surgical view; however, this technique requires one-lung ventilation (OLV). There are no guidelines about ventilatory modes during OLV in the prone position. We investigated the effects of volume-controlled (VCV) and pressure-controlled ventilation (PCV) on oxygenation and intrapulmonary shunt during OLV in the prone position in patients who underwent robot-assisted esophagectomy. METHODS: Eighteen patients, no major obstructive or restrictive pulmonary disease, were allocated randomly to one of two groups. In the first group (n = 9), OLV was started by VCV and the ventilator was switched to PCV after 30 minutes. In the second group (n = 9), the modes of ventilation were performed in the opposite order in the prone position. Hemodynamic and respiratory variables were obtained during OLV at the end of each ventilatory mode. RESULTS: There were no significant differences in arterial oxygen tension (PaO(2)), airway pressures, dynamic lung compliance, or physiologic dead space (Vd/Vt) during OLV between PCV and VCV in the prone position. Intrapulmonary shunt (Qs/Qt) was significantly lower with VCV than with PCV during OLV in the prone position (p = 0.044). CONCLUSION: PCV provides no advantages compared with VCV with regard to respiratory and hemodynamic variables during OLV in the prone position. Either ventilatory mode can be safely used for patients who undergo robot-assisted esophagectomy and who have normal body mass index and preserved pulmonary function.
Full Text
http://link.springer.com/article/10.1007%2Fs00464-008-0310-5
DOI
10.1007/s00464-008-0310-5
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Na, Sungwon(나성원) ORCID logo https://orcid.org/0000-0002-1170-8042
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Choi, Yong Seon(최용선) ORCID logo https://orcid.org/0000-0002-5348-864X
Hong, Yong Woo(홍용우)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104993
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