TY - JOUR T1 - Evaluation of Volume Controlled Ventilation Mode and Volume Guaranteed Pressure Controlled Ventilation Modes in Lateral Decubitus Position; Randomized Controlled Study TT - Lateral Dekübit Pozisyonda Hacim Kontrollü Ventilasyon Modu ve Hacim Garantili Basınç Kontrollü Ventilasyon Modlarının Değerlendirilmesi; Randomize Kontrollü Çalışma AU - Köksal, Veysel AU - Medetoğlu Köksal, Ela Nur AU - Gülbahar, Kenan AU - Çelik, Erkan Cem PY - 2024 DA - August Y2 - 2024 DO - 10.61745/jsmsau.1517872 JF - Atatürk University Faculty of Medicine Journal of Surgical Medical Sciences JO - Atatürk Univ Fac Med J Surg Med Sci PB - Atatürk Üniversitesi WT - DergiPark SN - 2822-3519 SP - 26 EP - 31 VL - 3 IS - 2 LA - en AB - Objectives: This study aims to examine the impact of two ventilation modes—volume-controlled ventilation (VCV) and volume-guaranteed pressure-controlled ventilation (PCV-VG)—on patient hemodynamic, lung mechanics, and alveolar gas exchange during laparoscopic surgery in the lateral decubitus position under general anaesthesia.Methods: The study included 60 patients, aged 18-65, classified as ASA I-II, who were scheduled for laparoscopic nephrectomy. Patients were randomly assigned to either the VCV or PCV-VG group. Parameters such as peak pressure (Ppeak), mean pressure (Pmean), PaO2, PaCO2, SaO2, and haematocrit (htc) were recorded at four time points: in the supine position before lateral decubitus (T1), 5 minutes after lateral decubitus (T2), at the end of surgery in lateral decubitus (T3), and in the supine position before extubation (T4). Additional data collected included patient demographics, surgery details, operation time, and the side of the operation.Results: When ventilation parameters and blood gas values at T1, T2, T3 and T4 were evaluated, significant differences were seen between the groups in Ppeak at T2 and Pmean at T3 (P.05). There was a significant difference in Ppeak, Pmean, htc, systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse parameters between the groups at different time periods (P KW - General Anesthesia KW - Laparoscopic Nephrectomy KW - Lateral Decubitus Position KW - Ventilation N2 - Amaç: Bu çalışmanın amacı, Genel anestezi altında lateral dekübit pozisyonda iki ventilasyon modunun (hacim kontrollü ventilasyon (VCV) ve hacim garantili basınç kontrollü ventilasyon (PCV-VG)) laparoskopik sırasında hasta hemodinamikleri, akciğer mekaniği ve alveoler gaz değişimi üzerindeki etkisini incelemeyi amaçlamaktadır. Yöntemler: Çalışmaya laparoskopik nefrektomi planlanan, ASA I-II olarak sınıflandırılan, 18-65 yaş arası 60 hasta dâhil edildi. Hastalar rastgele VCV veya PCV-VG grubuna ayrıldı. Hastaların demografik özellikleri, ameliyat ayrıntıları, ameliyat süresi ve ameliyatın tarafı ve tepe basıncı (Ppeak), ortalama basınç (Pmean), PaO2, PaCO2, SaO2 ve hematokrit (htc) gibi yanal dekübitten önce sırtüstü pozisyonda (T1), yanal dekübitten 5 dakika sonra (T1) T2), ameliyat sonunda lateral dekübitte (T3) ve ekstübasyon öncesi sırtüstü pozisyonda (T4) olmak üzere parametreler dört zaman noktasında kaydedildi. Bulgular: T1, T2, T3 ve T4'teki ventilasyon parametreleri ve kan gazı değerleri değerlendirildiğinde, gruplar arasında T2’de Ppeak ve T3'te ki Pmean'de anlamlı farklılıklar görüldü (P,05). Gruplar içerisinde farklı zaman dilimlerinde Ppeak, Pmean, htc, sistolik kan basıncı (SBP), diastolik kan basıncı (DBP) ve nabız parametrelerinde anlamlı fark mevcuttu (P CR - Cohen E. Physiology of the lateral position and one-lung ventilation. Chest Surg Clin N Am. 1997;7(4):753-771. CR - Assad OM, El Sayed AA, Khalil MA. Comparison of volume-controlled ventilation and pressure-controlled ventilation volume guaranteed during laparoscopic surgery in Trendelenburg position. J Clin Anesth. 2016;34:55-61. doi:10.1016/j.jclinane.2016.03.053 CR - Toker MK, Altıparmak B, Uysal Aİ, Demirbilek SG. [Comparison of pressure-controlled volume-guaranteed ventilation and volume-controlled ventilation in obese patients during gynecologic laparoscopic surgery in the Trendelenburg position]. Brazilian J Anesthesiol. 2019;69(6):553-560. doi:10.1016/j.bjan.2019.09.003 CR - Song SY, Jung JY, Cho MS, Kim JH, Ryu TH, Kim B Il. Volume-controlled versus pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation. Korean J Anesthesiol. 2014;67(4):258-263. doi:10.4097/kjae.2014.67.4.258 CR - Dion JM, McKee C, Tobias JD, et al. Ventilation during laparoscopic-assisted bariatric surgery: volume-controlled, pressure-controlled or volume-guaranteed pressure-regulated modes. Int J Clin Exp Med. 2014;7(8):2242-2247. CR - Bao C, Cao H, Shen Z, et al. Comparison of volume-controlled ventilation, pressure-controlled ventilation and pressure-controlled ventilation-volume guaranteed in infants and young children in the prone position: A prospective randomized study. J Clin Anesth. 2024;95:111440. doi:10.1016/j.jclinane.2024.111440 CR - Aldenkortt M, Lysakowski C, Elia N, Brochard L, Tramèr MR. Ventilation strategies in obese patients undergoing surgery: a quantitative systematic review and meta-analysis. Br J Anaesth. 2012;109(4):493-502. doi:10.1093/bja/aes338 CR - Lee JM, Lee SK, Kim KM, Kim YJ, Park EY. Comparison of volume-controlled ventilation mode and pressure-controlled ventilation with volume-guaranteed mode in the prone position during lumbar spine surgery. BMC Anesthesiol. 2019;19(1):133. doi:10.1186/s12871-019-0806-7 CR - Han J, Hu Y, Liu S, Hu Z, Liu W, Wang H. Volume-controlled ventilation versus pressure-controlled ventilation during spine surgery in the prone position: A meta-analysis. Ann Med Surg. 2022;78:103878. doi:10.1016/j.amsu.2022.103878 UR - https://doi.org/10.61745/jsmsau.1517872 L1 - https://dergipark.org.tr/tr/download/article-file/4077920 ER -