Comparison of Mechanical Power in Pressure-Regulated Volume Control and Volume-Controlled Ventilation Modes During Laparoscopic Cholecystectomy
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 80
- 试验地点
- 1
- 主要终点
- Device-Displayed Mechanical Power
研究概览
简要总结
This study investigates how different breathing machine (ventilator) settings affect the energy delivered to the lungs during surgery. Mechanical power is a measure of this energy, and high levels can sometimes lead to lung irritation. In clinical practice, a mode called Pressure-Regulated Volume Control (PRVC) is often used because it lowers the "peak" pressure in the airways, which is generally thought to be safer. However, doctors have noticed that even though the peak pressure goes down in PRVC mode, the total mechanical power displayed on the monitor might actually increase compared to the standard Volume-Controlled Ventilation (VCV) mode. In this study, patients undergoing gallbladder surgery will be monitored using both ventilation modes in a random order. The researchers will compare the machine-calculated mechanical power for both modes to see if the perceived benefit of lower peak pressure in PRVC actually results in lower overall energy transfer to the lungs.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Basic Science
- 盲法
- Single (Outcomes Assessor)
盲法说明
The data will be coded and analyzed by a researcher blinded to the ventilation mode sequences
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Patients undergoing elective laparoscopic cholecystectomy surgery.
- •Patients between 18 and 75 years of age.
- •American Society of Anesthesiologists (ASA) physical status I, II or III.
- •Body Mass Index (BMI) between 18.5 and 35 kg/m².
- •Voluntary written informed consent for participation.
排除标准
- •History of significant chronic obstructive pulmonary disease (COPD) or asthma.
- •Previous lung resection or major thoracic surgery.
- •Heavy smokers (more than 20 cigarettes per day).
- •Presence of spontaneous breathing effort during mechanical ventilation.
- •Conversion from laparoscopic surgery to open surgery during the procedure.
- •Emergency surgery cases.
- •Known pregnancy.
研究组 & 干预措施
group A; VCV First, Then PRVC
Following the stabilization of pneumoperitoneum, participants will be ventilated using the Volume-Controlled Ventilation (VCV) mode for 10 minutes. At the end of this period, respiratory data and mechanical power values will be recorded. Immediately after, the ventilator will be switched to the Pressure-Regulated Volume Control (PRVC) mode with equivalent settings. After another 10-minute stabilization period in PRVC mode, a second set of measurements will be recorded.
干预措施: Volume-Controlled Ventilation (VCV) (Device)
group A; VCV First, Then PRVC
Following the stabilization of pneumoperitoneum, participants will be ventilated using the Volume-Controlled Ventilation (VCV) mode for 10 minutes. At the end of this period, respiratory data and mechanical power values will be recorded. Immediately after, the ventilator will be switched to the Pressure-Regulated Volume Control (PRVC) mode with equivalent settings. After another 10-minute stabilization period in PRVC mode, a second set of measurements will be recorded.
干预措施: Pressure-Regulated Volume Control (PRVC) (Device)
group B; PRVC First, Then VCV
Following the stabilization of pneumoperitoneum, participants will be ventilated using the Pressure-Regulated Volume Control (PRVC) mode for 10 minutes. At the end of this period, respiratory data and mechanical power values will be recorded. Immediately after, the ventilator will be switched to the Volume-Controlled Ventilation (VCV) mode with equivalent settings. After another 10-minute stabilization period in VCV mode, a second set of measurements will be recorded.
干预措施: Volume-Controlled Ventilation (VCV) (Device)
group B; PRVC First, Then VCV
Following the stabilization of pneumoperitoneum, participants will be ventilated using the Pressure-Regulated Volume Control (PRVC) mode for 10 minutes. At the end of this period, respiratory data and mechanical power values will be recorded. Immediately after, the ventilator will be switched to the Volume-Controlled Ventilation (VCV) mode with equivalent settings. After another 10-minute stabilization period in VCV mode, a second set of measurements will be recorded.
干预措施: Pressure-Regulated Volume Control (PRVC) (Device)
结局指标
主要结局
Device-Displayed Mechanical Power
时间窗: At the end of a 10-minute stabilization period in each ventilation mode (VCV and PRVC).
The mechanical power value (expressed in Joules per minute - J/min) is automatically calculated and displayed on the monitor of the Mindray A9 anesthesia machine. This value represents the total energy delivered by the ventilator to the patient's respiratory system per minute. The study aims to compare how this machine-calculated value differs between the Volume-Controlled Ventilation (VCV) and Pressure-Regulated Volume Control (PRVC) modes under identical clinical conditions.
次要结局
未报告次要终点
研究者
Arif Timuroğlu, MD
Principal Investigator
Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital