Respiratory failure & ventilation
Comparison of volume-controlled ventilation, pressure-controlled ventilation and pressure-controlled ventilation-volume guaranteed in infants and young children in the prone position: A prospective randomized study
Authors' conclusion
In infants and young children undergoing spinal cord detethering surgery in the prone position, PCV-VG may be a better ventilation mode due to its ability to mitigate the increase in Ppeak and decrease in Cdyn while maintaining consistent VT.
Study context
- Population
- Children aged 1 month to 3 years undergoing elective spinal cord detethering surgery in the prone positionincluded in final analysis
- Participants
- 120 children
- Comparison
- Pressure-controlled ventilation (PCV) and pressure-controlled ventilation-volume guaranteed (PCV-VG) vs volume-controlled ventilation (VCV)
- VCVn = 40reference
- PCVn = 40
- PCV-VGn = 40
- Primary endpoint
- Intraoperative peak airway pressure (Ppeak)
Methodological detailssingle-centre, prospective
- Single-centre
- Prospective
Primary result
As reported in the abstract
Ppeak · T2 (10 min) and T3 (30 min) after prone positioning
- VCV showed higher Ppeak at T2 and T3 than PCV and PCV-VG
- VCV vs PCV: P = 0.015
- VCV vs PCV-VG: P = 0.002
- VCV vs PCV: P = 0.007
- VCV vs PCV-VG: P = 0.009
Secondary outcomes
| Outcome | P value |
|---|---|
| Prone-related decrease in dynamic compliance · T2 and T3PCV vs VCV · T2; decrease prevented | P = 0.008 |
| Prone-related decrease in dynamic compliance · T2 and T3PCV-VG vs VCV · T2; decrease prevented | P = 0.015 |
| Prone-related decrease in dynamic compliance · T2 and T3PCV vs VCV · T3; decrease prevented | P = 0.015 |
| Prone-related decrease in dynamic compliance · T2 and T3PCV-VG vs VCV · T3; decrease prevented | P = 0.014 |
Other secondary outcomes (respiratory and ventilation variables, gas exchange, serum lung injury biomarkers, haemodynamics, postoperative respiratory complications)
- No significant differences among the three groups
Original publication
Comparison of volume-controlled ventilation, pressure-controlled ventilation and pressure-controlled ventilation-volume guaranteed in infants and young children in the prone position: A prospective randomized study. J Clin Anesth. Published 8 March 2024. doi:10.
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