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Comparison of pressure-controlled ventilation with volume-controlled ventilation during one-lung ventilation: a systematic review and meta-analysis

Title
Comparison of pressure-controlled ventilation with volume-controlled ventilation during one-lung ventilation: a systematic review and meta-analysis
Author
정미애
Keywords
One-Lung Ventilation; Respiration; artificial
Issue Date
2016-08
Publisher
BIOMED CENTRAL LTD
Citation
BMC ANESTHESIOLOGY, v. 16, NO 1, Page. 1-11
Abstract
Background: Not only arterial hypoxemia but acute lung injury also has become the major concerns of one-lung ventilation (OLV). The use of pressure-controlled ventilation (PCV) for OLV offers the potential advantages of lower airway pressure and intrapulmonary shunt, which result in a reduced risk of barotrauma and improved oxygenation, respectively. Methods: We searched Medline, Embase, the Cochrane central register of controlled trials and KoreaMedto find publications comparing the effects of PCV with those of volume-controlled ventilation (VCV) during intraoperative OLV in adults. A meta-analysis of randomized controlled trials was performed using the Cochrane Review Methods. Results: Six studies (259 participants) were included. The PaO2/FiO(2) ratio in PCV was higher than in VCV [weighted mean difference (WMD) = 11.04 mmHg, 95 % confidence interval (CI) = 0.30 to 21.77, P = 0.04, I-2 = 3 %] and peak inspiratory pressure was significantly lower in PCV (WMD = -4.91 cm H2O, 95 % CI = -7.30 to -2.53, P ˂ 0.0001, I-2 = 91 %). No differences in PaCO2, tidal volume, heart rate and blood pressure were observed. There were also no differences incompliance, plateau and mean airway pressure. Conclusions: Our meta-analysis provided the evidence of improved oxygenation in PCV. However, it is difficult to draw any definitive conclusions due to the fact that the duration of ventilation in the studies reviewed was insufficient to reveal clinically relevant benefits or disadvantages of PCV. Significantly lower peak inspiratory pressure is the advantage of PCV.
URI
https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-016-0238-6http://repository.hanyang.ac.kr/handle/20.500.11754/75094
ISSN
1471-2253
DOI
10.1186/s12871-016-0238-6
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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