Effects of pressure-controlled ventilation targeting end-inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position: a randomized clinical trial
Abstract Background This study assessed the impact of pressure-controlled ventilation (PCV) focusing on end-inspiratory flow rate on the incidence of postoperative pulmonary complications (PPCs) and inflammation levels in patients undergoing spinal surgery in the prone position. Methods A total of 1...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-024-02439-3 |
| _version_ | 1797273461517713408 |
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| author | Na Wang Yong Ye Hui Lin Tingting Sun Yue Hu Yuanhang Shu Jing Tong Yong Tao Zeyu Zhao |
| author_facet | Na Wang Yong Ye Hui Lin Tingting Sun Yue Hu Yuanhang Shu Jing Tong Yong Tao Zeyu Zhao |
| author_sort | Na Wang |
| collection | DOAJ |
| description | Abstract Background This study assessed the impact of pressure-controlled ventilation (PCV) focusing on end-inspiratory flow rate on the incidence of postoperative pulmonary complications (PPCs) and inflammation levels in patients undergoing spinal surgery in the prone position. Methods A total of 187 patients who underwent posterior spinal surgery were enrolled and randomly divided into 3 groups: 61 in the volume-controlled ventilation (VCV) group (group V), 62 in the PCV-volume-guaranteed (VG) group (group P1), and 64 in the PCV-VG end-expiratory zero flow rate group (group P2). Indicators including tidal volume (VT), peak airway pressure (Ppeak), and dynamic lung compliance (Cdyn) were recorded. The Ppeak, Cdyn, PETCO2, and oxygenation index (PaO2/FiO2) after intubation (T0), after prone position (T1), 60 min after prone position (T2), and after supine position at the end of surgery (T3) of the three groups were collected. Results In the within-group comparison, compared with T0, Ppeak increased at T1 − 2 in groups V and P1 (P < 0.01), whereas it decreased at T1 − 3 in group P2 (P < 0.01). Cdyn decreased at T1 − 2 and PaO2/FiO2 increased at T1 − 3 in all three groups (P < 0.01), and PaO2/FiO2 increased at T1 − 3 (P < 0.01). Compared with group V, Ppeak decreased at T0 − 3 in group P1 (P < 0.01) and at T1 − 3 in group P2 (P < 0.01), while Cdyn increased at T0 − 3 in groups P1 and P2 (P < 0.01). Compared with group P1, Ppeak was elevated at T0 (P < 0.01) and decreased at T1 − 3 (P < 0.05), and Cdyn was elevated at T0 − 3 in group P2 (P < 0.01). The total incidence of PPCs in group P2 was lower than that in group V (P < 0.01). Compared with the preoperative period, serum interleukin 6 (IL-6) and C-reactive protein (CRP) levels were increased at 24 and 72 h after surgery in group V (P < 0.01), whereas that was increased at 24 h after surgery in group P1 and group P2 (P < 0.01). Compared with group V, serum IL-6 and CRP levels were reduced at 24 h after surgery in groups P1 and P2 (P < 0.01 or < 0.05). Conclusion In patients undergoing spinal surgery in the prone position, PCV-VG targeting an end-inspiratory zero flow rate lowers the incidence of PPCs and inflammation levels. |
| first_indexed | 2024-03-07T14:44:37Z |
| format | Article |
| id | doaj.art-59109e1ff44149b382ac945145d22827 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-07T14:44:37Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-59109e1ff44149b382ac945145d228272024-03-05T20:04:52ZengBMCBMC Anesthesiology1471-22532024-02-012411910.1186/s12871-024-02439-3Effects of pressure-controlled ventilation targeting end-inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position: a randomized clinical trialNa Wang0Yong Ye1Hui Lin2Tingting Sun3Yue Hu4Yuanhang Shu5Jing Tong6Yong Tao7Zeyu Zhao8Department of Anesthesia Operation, The First People’s Hospital of Shuangliu District, Chengdu, West China Airport Hospital of Sichuan University)Department of Anesthesia Operation, The First People’s Hospital of Shuangliu District, Chengdu, West China Airport Hospital of Sichuan University)Department of Anesthesia Operation, The First People’s Hospital of Shuangliu District, Chengdu, West China Airport Hospital of Sichuan University)Department of Anesthesia Operation, The First People’s Hospital of Shuangliu District, Chengdu, West China Airport Hospital of Sichuan University)Department of Anesthesia Operation, The First People’s Hospital of Shuangliu District, Chengdu, West China Airport Hospital of Sichuan University)Department of Anesthesia Operation, The First People’s Hospital of Shuangliu District, Chengdu, West China Airport Hospital of Sichuan University)Department of Anesthesia Operation, The First People’s Hospital of Shuangliu District, Chengdu, West China Airport Hospital of Sichuan University)Department of Anesthesia Operation, The First People’s Hospital of Shuangliu District, Chengdu, West China Airport Hospital of Sichuan University)Department of Anesthesiology, Sichuan Provincial Rehabilitation Hospital Affiliated Chengdu University of Traditional Chinese MedicineAbstract Background This study assessed the impact of pressure-controlled ventilation (PCV) focusing on end-inspiratory flow rate on the incidence of postoperative pulmonary complications (PPCs) and inflammation levels in patients undergoing spinal surgery in the prone position. Methods A total of 187 patients who underwent posterior spinal surgery were enrolled and randomly divided into 3 groups: 61 in the volume-controlled ventilation (VCV) group (group V), 62 in the PCV-volume-guaranteed (VG) group (group P1), and 64 in the PCV-VG end-expiratory zero flow rate group (group P2). Indicators including tidal volume (VT), peak airway pressure (Ppeak), and dynamic lung compliance (Cdyn) were recorded. The Ppeak, Cdyn, PETCO2, and oxygenation index (PaO2/FiO2) after intubation (T0), after prone position (T1), 60 min after prone position (T2), and after supine position at the end of surgery (T3) of the three groups were collected. Results In the within-group comparison, compared with T0, Ppeak increased at T1 − 2 in groups V and P1 (P < 0.01), whereas it decreased at T1 − 3 in group P2 (P < 0.01). Cdyn decreased at T1 − 2 and PaO2/FiO2 increased at T1 − 3 in all three groups (P < 0.01), and PaO2/FiO2 increased at T1 − 3 (P < 0.01). Compared with group V, Ppeak decreased at T0 − 3 in group P1 (P < 0.01) and at T1 − 3 in group P2 (P < 0.01), while Cdyn increased at T0 − 3 in groups P1 and P2 (P < 0.01). Compared with group P1, Ppeak was elevated at T0 (P < 0.01) and decreased at T1 − 3 (P < 0.05), and Cdyn was elevated at T0 − 3 in group P2 (P < 0.01). The total incidence of PPCs in group P2 was lower than that in group V (P < 0.01). Compared with the preoperative period, serum interleukin 6 (IL-6) and C-reactive protein (CRP) levels were increased at 24 and 72 h after surgery in group V (P < 0.01), whereas that was increased at 24 h after surgery in group P1 and group P2 (P < 0.01). Compared with group V, serum IL-6 and CRP levels were reduced at 24 h after surgery in groups P1 and P2 (P < 0.01 or < 0.05). Conclusion In patients undergoing spinal surgery in the prone position, PCV-VG targeting an end-inspiratory zero flow rate lowers the incidence of PPCs and inflammation levels.https://doi.org/10.1186/s12871-024-02439-3End-inspiratory flow rateGeneral anesthesiaPressure-controlled ventilationProne positionSpinal surgery |
| spellingShingle | Na Wang Yong Ye Hui Lin Tingting Sun Yue Hu Yuanhang Shu Jing Tong Yong Tao Zeyu Zhao Effects of pressure-controlled ventilation targeting end-inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position: a randomized clinical trial BMC Anesthesiology End-inspiratory flow rate General anesthesia Pressure-controlled ventilation Prone position Spinal surgery |
| title | Effects of pressure-controlled ventilation targeting end-inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position: a randomized clinical trial |
| title_full | Effects of pressure-controlled ventilation targeting end-inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position: a randomized clinical trial |
| title_fullStr | Effects of pressure-controlled ventilation targeting end-inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position: a randomized clinical trial |
| title_full_unstemmed | Effects of pressure-controlled ventilation targeting end-inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position: a randomized clinical trial |
| title_short | Effects of pressure-controlled ventilation targeting end-inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position: a randomized clinical trial |
| title_sort | effects of pressure controlled ventilation targeting end inspiratory flow rate on pulmonary complications and inflammation levels in patients undergoing spinal surgery in the prone position a randomized clinical trial |
| topic | End-inspiratory flow rate General anesthesia Pressure-controlled ventilation Prone position Spinal surgery |
| url | https://doi.org/10.1186/s12871-024-02439-3 |
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