The comparative study of effects of volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) on hemodynamics and respiratory mechanics in patients undergoing spine surgeries in prone position-prospective randomised controlled study.
试验速览
- 阶段
- 2/3 期
- 状态
- 尚未招募
- 发起方
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- To compare the effect of PCV with VCV on lung mechanics, oxygenation, ventilation and intra-operative bleeding.
研究概览
简要总结
Volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) are two traditional ventilation modes in operating room, with different respiratory mechanics. The two ventilation modes have different influences on intrathoracic pressure and consequently venous return.During general anaesthesia, changing from supine to prone position may have adverse effects on oxygenation, ventilation and circulation.
Prone position interferes with lung mechanics by decreasing the pulmonary compliance and increasing the airway pressure1-3. High airway pressure may in turn impair venous return to heart, decrease cardiac output and increase the systemic venous pressure. Different modes of mechanical ventilation are used to balance respiratory mechanics, gas exchange and hemodynamics.
Volume-controlled ventilation (VCV) has been widely used as a positive-pressure ventilation (PPV) method during anesthesia, but this method does increase airway pressure when chest compliance is decreased as occurs in during prone position surgeries. This increased airway pressure will be reflected as increased epidural venous pressure leading to increased surgical bleeding. On the other hand, pressure-controlled ventilation (PCV) limits the peak airway pressure (Ppeak) and reduces intrathoracic pressure thereby improving venous return and cardiac output.4
However, advantage of PCV over VCV in improvement of oxygenation and ventilation has shown inconsistent results. To surgeons, the major problems encountered performing spine surgery are those of exposure and bleeding. To anaesthesiologists, the major problems noted in those patients are difficulties with ventilation and with cardiac dysfunction if the abdomen and chest are restricted.5
The present study aims to compare the effects of PCV with VCV on lung mechanics, oxygenation, ventilation and hemodynamics.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- Participant Blinded
入排标准
- 年龄范围
- 20.00 Year(s) 至 60.00 Year(s)（—）
- 性别
- All
入选标准
- •ASA-1 and ASA-2 patients aged 20-60 years scheduled for elective spine surgeries in prone position under general anaesthesia will be enrolled for the study.
排除标准
- •Body mass index (BMI) >30 Documented autonomic neuropathy Obstructive or restrictive lung diseases Repeat spine surgeries.
结局指标
主要结局
To compare the effect of PCV with VCV on lung mechanics, oxygenation, ventilation and intra-operative bleeding.
时间窗: To compare the effects of respiratory mechanics after intubation under supine position, after proning, then at 20 minutes , 30 minutes, 60 minutes, 90 minutes, 120 mins , 150 minutes, 180 minutes, till the end of procedure
次要结局
- To evaluate the effect of these two modes of ventilation on hemodynamics.(To study the hemodynamic changes)
研究者
DrAshwini H
Rajarajeswari medical college and hospital