Respiratory failure & ventilation
Effect of pressure-controlled ventilation and volume-controlled ventilation for laparoscopic surgery in the Trendelenburg position: a systematic review and meta-analysis
Authors' conclusion
Our meta-analysis suggests that in laparoscopic surgery in the Trendelenburg position, PCV or PCV-VG can provide a lower Ppeak and higher Cdyn throughout surgery but cannot offer better oxygenation than VCV.
Study context
- Population
- Patients undergoing laparoscopic surgery in the Trendelenburg position16 studies
- Comparison
- Pressure-controlled ventilation (PCV) or PCV-VG vs volume-controlled ventilation (VCV)
- Outcome
- Peak airway pressure (Ppeak), plateau airway pressure (Pplat), dynamic compliance (Cdyn), and blood gas analysis
Pooled result
As reported in the abstract
Ppeak and Cdyn · T2 = 15-40-min, T3 = 60-min, T4 = 120-min post-pneumoperitoneum and Trendelenburg position
Each group vs VCVMD (95% CI)P value
PCVCdyn, T2
3.15(1.53–4.77)
P = 0.0001PCVCdyn, T3
2.78(1.43–4.14)
P < 0.01PCV-VGCdyn, T3
4.44(2.23–6.66)
P < 0.01PCV-VGCdyn, T4
3.61(1.31–5.91)
P = 0.002- PCV · Ppeak, T2
- MD - 4.28 (95% CI - 5.91 to - 2.64); P < 0.01
- PCV · Ppeak, T3
- MD - 4.51 (95% CI - 5.41 to - 3.6); P < 0.01
- PCV · Ppeak, T4
- MD - 5.63 (95% CI - 7.35 to - 3.91); P < 0.01
- PCV-VG · Ppeak, T2
- MD - 3.99 (95% CI - 7.2 to - 0.78); P = 0.01
- PCV-VG · Ppeak, T3
- MD - 3.46 (95% CI - 6.5 to - 0.42); P = 0.03
Original publication
Effect of pressure-controlled ventilation and volume-controlled ventilation for laparoscopic surgery in the Trendelenburg position: a systematic review and meta-analysis. Perioper Med (Lond). Published 13 May 2025. doi:10.
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