The ultrasound estimation of extravascular lung water in volume controlled versus pressure controlled ventilation after one lung ventilation in Thoracoscopic surgery. A-comparative study

Abstract

Background Thoracoscopic surgeries are an absolute indication of one lung ventilation OLV, the choice of using volume-controlled ventilation (VCV) or pressure controlled ventilation (PCV) remains controversial. Respiratory complications are major cause of postoperative morbidity which is associated with increased extravascular lung water (EVLW). Assessment of (EVLW) helps in early detection and treatment of respiratory complications. Lung ultrasound (LUS) has been suggested as reliable method of assessment of EVLW. This study was designed to figure out whether there was any difference in OLV by either PCV or VCV on EVLW water in the ventilated lung using LUS score and arterial oxygenation.Methodology 50 patients were randomly assigned into two groups; Group V: received VCV (Vt 7 ml/kg ideal body weight) Group P: received PCV (To achieve Vt 7 ml/kg ideal body weight, Pmax 30 cmh2o)Results We found that both techniques PCV and VCV showed no statistically significant differences as regards the ultrasound score at different timings of measurement; (T0) before induction of anesthesia, (T5) immediately at the end of operation after extubation, and (T6) 2 hours after ICU admission. Where P values were 0.525, 0.309, and 0.597 consecutively, we also found there were no statistically significant differences between the two groups regarding hemodynamics, arterial blood gases, ventilatory parameters.Conclusion We concluded that when utilizing VCV & PCV in OLV in thoracospic surgeries there was no statistically significant difference regarding EVLW score measured by LUS in the ventilated lung.

Keywords

• Thoracoscopic surgeries
• one lung ventilation
• volume controlled ventilation
• pressure controlled ventilation
• extravascular lung water
• lung ultrasound