Comparison of intraoperative volume and pressure-controlled ventilation modes in patients who undergo open heart surgery

Hosten T., KUŞ A., Gumus E., YAVUZ Ş., İRKİL S., Solak M.

JOURNAL OF CLINICAL MONITORING AND COMPUTING, cilt.31, sa.1, ss.75-84, 2017 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 31 Sayı: 1
  • Basım Tarihi: 2017
  • Doi Numarası: 10.1007/s10877-016-9824-x
  • Dergi Adı: JOURNAL OF CLINICAL MONITORING AND COMPUTING
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.75-84
  • Anahtar Kelimeler: Open heart surgery, Ventilation, Volume controlled, Pressure controlled, Oxygenation, PaO2/fiO(2) ratio, CARDIOPULMONARY BYPASS, MECHANICAL VENTILATION, GAS-EXCHANGE, INFLAMMATORY RESPONSE, RESPIRATORY MECHANICS, INSPIRATORY FLOW, CARDIAC-SURGERY, AIRWAY PRESSURE, PULMONARY, OXYGENATION
  • Kocaeli Üniversitesi Adresli: Evet

Özet

Respiratory problems occur more frequently in patients who undergo open heart surgery. Intraoperative and postoperative ventilation strategies can prevent these complications and reduce mortality. We hypothesized that PCV would have better effects on gas exchange, lung mechanics and hemodynamics compared to VCV in CABG surgery. Our primary outcome was to compare the PaO2/FiO(2) ratio. Patients were randomized into two groups, (VCV, PCV) consisting of 30 individuals each. Two patients were excluded from the study. I/E ratio was adjusted to 1:2 and, RR:10/min fresh air gas flow was set at 3L/min in all patients. In the VCV group TV was set at 8 mL/kg of the predicted body weight. In the PCV group, peak inspiratory pressure was adjusted to the same tidal volume with the VCV group. PaO2/FiO2 was found to be higher with PCV at the end of the surgery. Time to extubation and ICU length of stay was shorter with PCV. Ppeak was similar in both groups. Pplateau was lower and Pmean was higher at the and of the surgery with PCV compared to VCV. The hemodynamic effects of both ventilation modes were found to be similar. PVC may be preferable to VCV in patients who undergo open heart surgery. However, it would be convenient if our findings are supported by similar studies.