Lung ultrasound score-based perioperative assessment of pressure-controlled ventilationvolume guaranteed or volume-controlled ventilation in geriatrics: A prospective randomized controlled trial

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Abstract

Purpose: Recent studies have shown the potential benefits of pressure-controlled ventila-tion-volume guaranteed (PCV-VG) compared to volume-controlled ventilation (VCV), but the results were not impressive. We assessed the effects of PCV-VG versus VCV in elderly patients by using lung ultrasound score (LUS). Patients and methods: Elderly patients (aged 65–90 years) scheduled for hip joint surgery were randomly assigned to either the PCV-VG or VCV group during general anesthesia. LUS and mechanical ventilator parameters were evaluated before induction, 30 mins after a semi-lateral position change, during supine repositioning before awakening, and 15 mins after arrival to the post-anesthesia care unit (PACU). Pulmonary function tests were per-formed before and after surgery. Other recovery indicators were also assessed in the PACU. Results: A total of 76 patients (40 for PCV-VG and 36 for VCV) were included this study. Demographic data showed no significant difference between the two groups. In both groups, LUSs before induction were significantly lower than those at other time points. LUSs of the VCV group were significantly increased during perioperative periods compared with the PCV-VG group (p=0.049). Visualized LUS modeling suggested an intuitive difference in the two groups and unequal distribution in lung aeration. Higher dynamic compliance and lower inspiratory peak pressure were observed in the PVC-VG group compared to the VCV group (33.54 vs 27.36, p<0.001; 18.93 vs 21.19, p<0.001, respectively). Postoperative forced vital capacity of the VCV group was lower than that of PCV-VG group, but this result was not significant (2.06 vs 1.79, respectively; p=0.091). The other respiratory data are comparable between the two groups. Conclusion: The PCV-VG group showed better LUS compared with the VCV group. Moreover, LUS modeling in both groups suggests non-homogeneous and positional change in lung aerations during surgery.

Original languageEnglish
Pages (from-to)1319-1329
Number of pages11
JournalClinical Interventions in Aging
Volume14
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Geriatrics
Ventilation
Randomized Controlled Trials
Pressure
Lung
Anesthesia
Perioperative Period
Respiratory Function Tests
Vital Capacity
Hip Joint
Mechanical Ventilators
Polyvinyl Chloride
General Anesthesia
Compliance
Demography

Keywords

  • Geriatrics
  • Hip joint surgery
  • Lung physiology
  • Mechanical ventilation
  • Ultrasonography

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

@article{855764a01ccf432aa2cf1b0ad509da12,
title = "Lung ultrasound score-based perioperative assessment of pressure-controlled ventilationvolume guaranteed or volume-controlled ventilation in geriatrics: A prospective randomized controlled trial",
abstract = "Purpose: Recent studies have shown the potential benefits of pressure-controlled ventila-tion-volume guaranteed (PCV-VG) compared to volume-controlled ventilation (VCV), but the results were not impressive. We assessed the effects of PCV-VG versus VCV in elderly patients by using lung ultrasound score (LUS). Patients and methods: Elderly patients (aged 65–90 years) scheduled for hip joint surgery were randomly assigned to either the PCV-VG or VCV group during general anesthesia. LUS and mechanical ventilator parameters were evaluated before induction, 30 mins after a semi-lateral position change, during supine repositioning before awakening, and 15 mins after arrival to the post-anesthesia care unit (PACU). Pulmonary function tests were per-formed before and after surgery. Other recovery indicators were also assessed in the PACU. Results: A total of 76 patients (40 for PCV-VG and 36 for VCV) were included this study. Demographic data showed no significant difference between the two groups. In both groups, LUSs before induction were significantly lower than those at other time points. LUSs of the VCV group were significantly increased during perioperative periods compared with the PCV-VG group (p=0.049). Visualized LUS modeling suggested an intuitive difference in the two groups and unequal distribution in lung aeration. Higher dynamic compliance and lower inspiratory peak pressure were observed in the PVC-VG group compared to the VCV group (33.54 vs 27.36, p<0.001; 18.93 vs 21.19, p<0.001, respectively). Postoperative forced vital capacity of the VCV group was lower than that of PCV-VG group, but this result was not significant (2.06 vs 1.79, respectively; p=0.091). The other respiratory data are comparable between the two groups. Conclusion: The PCV-VG group showed better LUS compared with the VCV group. Moreover, LUS modeling in both groups suggests non-homogeneous and positional change in lung aerations during surgery.",
keywords = "Geriatrics, Hip joint surgery, Lung physiology, Mechanical ventilation, Ultrasonography",
author = "Kim, {Young Sung} and won, {young ju} and Lee, {Dong Kyu} and Lim, {Byung Gun} and Heezoo Kim and Lee, {Il Ok} and Yun, {Jin Hee} and Myounghoon Kong",
year = "2019",
month = "1",
day = "1",
doi = "10.2147/CIA.S212334",
language = "English",
volume = "14",
pages = "1319--1329",
journal = "Clinical Interventions in Aging",
issn = "1176-9092",
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T1 - Lung ultrasound score-based perioperative assessment of pressure-controlled ventilationvolume guaranteed or volume-controlled ventilation in geriatrics

T2 - A prospective randomized controlled trial

AU - Kim, Young Sung

AU - won, young ju

AU - Lee, Dong Kyu

AU - Lim, Byung Gun

AU - Kim, Heezoo

AU - Lee, Il Ok

AU - Yun, Jin Hee

AU - Kong, Myounghoon

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: Recent studies have shown the potential benefits of pressure-controlled ventila-tion-volume guaranteed (PCV-VG) compared to volume-controlled ventilation (VCV), but the results were not impressive. We assessed the effects of PCV-VG versus VCV in elderly patients by using lung ultrasound score (LUS). Patients and methods: Elderly patients (aged 65–90 years) scheduled for hip joint surgery were randomly assigned to either the PCV-VG or VCV group during general anesthesia. LUS and mechanical ventilator parameters were evaluated before induction, 30 mins after a semi-lateral position change, during supine repositioning before awakening, and 15 mins after arrival to the post-anesthesia care unit (PACU). Pulmonary function tests were per-formed before and after surgery. Other recovery indicators were also assessed in the PACU. Results: A total of 76 patients (40 for PCV-VG and 36 for VCV) were included this study. Demographic data showed no significant difference between the two groups. In both groups, LUSs before induction were significantly lower than those at other time points. LUSs of the VCV group were significantly increased during perioperative periods compared with the PCV-VG group (p=0.049). Visualized LUS modeling suggested an intuitive difference in the two groups and unequal distribution in lung aeration. Higher dynamic compliance and lower inspiratory peak pressure were observed in the PVC-VG group compared to the VCV group (33.54 vs 27.36, p<0.001; 18.93 vs 21.19, p<0.001, respectively). Postoperative forced vital capacity of the VCV group was lower than that of PCV-VG group, but this result was not significant (2.06 vs 1.79, respectively; p=0.091). The other respiratory data are comparable between the two groups. Conclusion: The PCV-VG group showed better LUS compared with the VCV group. Moreover, LUS modeling in both groups suggests non-homogeneous and positional change in lung aerations during surgery.

AB - Purpose: Recent studies have shown the potential benefits of pressure-controlled ventila-tion-volume guaranteed (PCV-VG) compared to volume-controlled ventilation (VCV), but the results were not impressive. We assessed the effects of PCV-VG versus VCV in elderly patients by using lung ultrasound score (LUS). Patients and methods: Elderly patients (aged 65–90 years) scheduled for hip joint surgery were randomly assigned to either the PCV-VG or VCV group during general anesthesia. LUS and mechanical ventilator parameters were evaluated before induction, 30 mins after a semi-lateral position change, during supine repositioning before awakening, and 15 mins after arrival to the post-anesthesia care unit (PACU). Pulmonary function tests were per-formed before and after surgery. Other recovery indicators were also assessed in the PACU. Results: A total of 76 patients (40 for PCV-VG and 36 for VCV) were included this study. Demographic data showed no significant difference between the two groups. In both groups, LUSs before induction were significantly lower than those at other time points. LUSs of the VCV group were significantly increased during perioperative periods compared with the PCV-VG group (p=0.049). Visualized LUS modeling suggested an intuitive difference in the two groups and unequal distribution in lung aeration. Higher dynamic compliance and lower inspiratory peak pressure were observed in the PVC-VG group compared to the VCV group (33.54 vs 27.36, p<0.001; 18.93 vs 21.19, p<0.001, respectively). Postoperative forced vital capacity of the VCV group was lower than that of PCV-VG group, but this result was not significant (2.06 vs 1.79, respectively; p=0.091). The other respiratory data are comparable between the two groups. Conclusion: The PCV-VG group showed better LUS compared with the VCV group. Moreover, LUS modeling in both groups suggests non-homogeneous and positional change in lung aerations during surgery.

KW - Geriatrics

KW - Hip joint surgery

KW - Lung physiology

KW - Mechanical ventilation

KW - Ultrasonography

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