Comparative study of the effects of volume-controlled ventilation vs. pressure-controlled volume guaranteed ventilation in patients with obesity during laparoscopic surgery

Abstract

Background & objective: The anesthetists have been experimenting with different modes of mechanical ventilation during general anesthesia.  The objective of this study was to evaluate the efficacy of Pressure Controlled Ventilation-Volume Guaranteed (PCV-VG) mode in comparison to volume-controlled ventilation (VCV) mode in obese patients undergoing laparoscopic surgery in the Trendelenburg position, with a focus on their lung compliance and Oxygenation Index (OI).

Methodology: This randomized controlled clinical trial involved 64 obese patients of both sexes, with a Body Mass Index (BMI) of ≥30 kg/m², and classified as American Society of Anesthesiologists (ASA) class I or II. The participants were randomly assigned to one of the two groups: the study group (Group P) using PCV-VG and the control group (Group V) using VCV. Hemodynamic and respiratory parameters were monitored.

Results: The arterial oxygen partial pressure (PaO₂) and lung compliance were significantly higher in Group P compared to Group V (P < 0.05). Conversely, the peak pressure (P peak) and plateau pressure (Pplat) along with the mean pressure (P mean) as well as the OI were significantly lower in Group P compared to Group V (P < 0.05).

Conclusion: PCV-VG significantly improves lung compliance and oxygenation while maintaining lower peak and plateau pressures, with comparable hemodynamic stability and PaCO₂ levels.

Abbreviations: BMI: Body Mass Index, OI: Oxygenation Index, PCV-VG: Pressure Controlled Ventilation-Volume Guaranteed, PIP: Peak Inspiratory Pressure, PRVC- pressure-regulated volume-controlled, V_T: tidal volume, VCV: volume-controlled ventilation

Keywords: Volume-Controlled Ventilation; Pressure-Controlled Ventilation Volume-Guaranteed; Trendelenburg Position; Obesity; Airway Pressures

Citation: Soliman AM, El Seidy MI, Taha SS,  El Agamy AES, Youssef AM. Comparative study of the effects of volume-controlled ventilation vs. pressure-controlled volume guaranteed ventilation in patients with obesity during laparoscopic surgery. Anaesth. pain intensive care 2025;29(2):318-324. DOI: 10.35975/apic.v29i2.2722

Received: September 02, 2024; Reviewed: October 23, 2024; Accepted: January 01, 2025