Volume-controlled ventilation versus pressure-controlled ventilation and recruitment maneuvers in video-assisted thoracoscopic surgery

Aims: Various ventilation strategies can be applied to prevent lung injury during one-lung ventilation (OLV). We compared intraoperative ventilation strategies in terms of haemodynamic and respiratory parameters in video-assisted thoracoscopic surgery (VATS). Methods: Sixty VATS patients, with American Society of Anesthesiologists score of I-III, receiving volume-controlled ventilation (VCV) (Group V) (n=30) or pressure-controlled ventilation (PCV) and recruitment maneuver (RM) (Group P) (n=30) were included in this prospective study. Mean arterial pressure (MAP), peripheral oxygen saturation (SpO2), tidal volume (TV), airway pressures, compliance, and arterial blood gas values were recorded. In Group P, RM was applied after the 15th minute of OLV. The clinical efficacy and safety of VCV and PCV during VATS were evaluated. Results: The MAP and PaO2 were similar between groups throughout the follow-up (p>0.05). The peak inspiratory pressure (PIP) and Pplateau in Group V were higher than those in Group P (p<0.05). In Group P, there was an increase in TV, airway pressures, and compliance values at the 1st, 2nd, and 3rd minutes of RM (p<0.05). No significant change was observed in SpO2, PaO2, airway pressures, and compliance in Group P at post-RM 15th min (p>0.05). Conclusions: The ventilation modes did not have clinical superiority over each other. Nonetheless, lower PIP and Pplateau values found during PCV were considered advantage. In Group P, the RM applied during OLV increased compliance and TV. However, extensive research is needed to develop RM models that will ensure improvements in respiratory parameters will last longer.