Abstract No.: ABS3339: Effects of volume controlled and pressure controlled volume guaranteed modes of ventilation on respiratory dynamics during laparoscopic surgery in children: A prospective observational study

Abstract

Background & Aims:The aim of the study was to compare the effects of Volume controlled ventilation (VCV) and Pressure controlled volume guaranteed ventilation (PCV-VG), which delivers the target tidal volume at the lowest possible pressure, on respiratory dynamics during paediatric laparoscopic surgery.Methods:In this prospective observational study, 52 patients of 0-15 years were included; (n= 26) each for VCV and PCV-VG.fraction of inspired oxygen(FiO2)50%, tidal volume 6-10 ml/kg, age appropriate respiratory rate (RR) to maintain end-tidal carbon dioxide (EtCO2) between 35-40 mm Hg, PEEP 4 cm and P-limit 10 cm above the initial peak pressure were set. Peak inspiratory pressure (PIP), Plateau pressure (PlatP), expiredtidal volume (VTe)/kg, compliance (Compl), airway resistance (R), ETCO2 and saturation of O2 (SaO2)were noted after intubation, creation of pneumoperitoneum, changing position, desufflation and change of position to supine.Results:Demographic criteria, haemodynamic parameters, set and measured respiratory parameters at all time points were similar inboth groups. Trendelenburg position was required in 11 children in VCV and 13 in PCV-VG group. Following this, there was similar increase in PIP, PlatP, R and decrease in CompL in both groups. However, significant increase in RR was required inVCV group (percentage change in RR- —VCV: 3.5±5.01, PCV-VG : 0±00, p=0.039) to maintain normal ETCO2.Conclusion:Either VCV or PCV-VG mode of ventilation, can be used during paediatric laparoscopic surgery in supine position.However, with Trendelenburg position, PCV-VG provides a marginal advantage over VCV mode of ventilation.