Key result
Pressure-controlled ventilation improved arterial oxygenation and reduced peak airway pressure compared to volume-controlled ventilation in obese patients undergoing laparoscopic cholecystectomy.
Why the study?
Maintenance of oxygenation is a primary concern in obese patients undergoing laparoscopy, and there are no specific guidelines for selection of ventilatory modes in morbidly obese patients.
Does pressure-controlled ventilation improve oxygenation and respiratory mechanics compared to volume-controlled ventilation in obese patients undergoing laparoscopic cholecystectomy?
RCT (n=100)
Simple randomization
No
Does pressure-controlled ventilation improve oxygenation and respiratory mechanics compared to volume-controlled ventilation in obese patients undergoing laparoscopic cholecystectomy?
Pressure-controlled ventilation improves arterial oxygenation and lowers peak airway pressure compared to volume-controlled ventilation in obese patients undergoing laparoscopic cholecystectomy.
Answers are grounded in this paper and cite their sources.
Supports preferring PCV over VCV in obese laparoscopic cholecystectomy; extends RCT evidence on ventilation mode selection.
Obesity is a well -established risk factor for cholelithiasis for which laparoscopic cholecystectomy is the routinely performed surgery [1]. During laparoscopy the respiratory mechanics are affected by obesity and pneumoperitoneum, but vary little with body position [2]. Hence maintenance of oxygenation is one of the main concern in the anaesthetic management of obese patients [3]. There are no specific guidelines for selection of ventilatory modes in morbidly obese patients [4]. Advancement in our understanding of pressure-volume curves and the recent demonstration of microscopic shear stress lung injury have changed the whole concept of safe range of pressure and volume in mechanical ventilation [5].
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Chukka Divya G Vijaya (2023) conducted an RCT in Obesity and cholelithiasis (n=100). Pressure-controlled ventilation vs. Volume-controlled ventilation was evaluated on PaO2 at 35 minutes after pneumoperitoneum (mm Hg) (p=0.002). Pressure-controlled ventilation improved arterial oxygenation and reduced peak airway pressure compared to volume-controlled ventilation in obese patients undergoing laparoscopic cholecystectomy.
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