Journal
ANAESTHESIA
Volume 77, Issue 11, Pages 1219-1227Publisher
WILEY
DOI: 10.1111/anae.15848
Keywords
postoperative pulmonary complications; ventilation mode; volume-controlled ventilation; pressure-controlled ventilation; pressure-controlled with volume guaranteed ventilation
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This study evaluated the impact of three different mechanical ventilation modes on postoperative pulmonary complications in patients undergoing lung resection surgery with one-lung ventilation. The results showed that the choice of ventilation mode did not influence the risk of developing postoperative pulmonary complications.
The effect of intra-operative mechanical ventilation modes on pulmonary outcomes after thoracic surgery with one-lung ventilation has not been well established. We evaluated the impact of three common ventilation modes on postoperative pulmonary complications in patients undergoing lung resection surgery. In this two-centre randomised controlled trial, 1224 adults scheduled for lung resection surgery with one-lung ventilation were randomised to one of three groups: volume-controlled ventilation; pressure-controlled ventilation; and pressure-control with volume guaranteed ventilation. Enhanced recovery after surgery pathways and lung-protective ventilation protocols were implemented in all groups. The primary outcome was a composite of postoperative pulmonary complications within the first seven postoperative days. The outcome occurred in 270 (22%), with 87 (21%) in the volume control group, 89 (22%) in the pressure control group and 94 (23%) in the pressure-control with volume guaranteed group (p = 0.831). The secondary outcomes also did not differ across study groups. In patients undergoing lung resection surgery with one-lung ventilation, the choice of ventilation mode did not influence the risk of developing postoperative pulmonary complications. This is the first randomised controlled trial examining the effect of three ventilation modes on pulmonary outcomes in patients undergoing lung resection surgery.
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