Effects of different ventilation modes on one-lung ventilation: a Meta-analysis

Abstract

Objective To evaluate the effects of pressure controlled ventilation(PCV) and volume control ventilation(VCV) on the respiratory mechanics and circulation of patients during one-lung ventilation(OLV). Methods We searched the PubMed, Embase and Cochrane libraries for all randomized controlled trials(RCT) from the establishment of library to February 2016 about the use of PCV and VCV during operation. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration′s RevMan 5.0 software. Results A total of 14 studies were selected, including 964 patients(480 for PCV and 484 for VCV). Compared with group VCV, group PCV showed lower mean airway pressure(Pmean) [odds ratio(OR)=-0.22, 95%CI(-0.42,-0.01), P<0.05] before chest opening(T1), lower peak airway pressure(Ppeak)[weighted mean difference(WMD)=-1.37, 95%CI(-1.69,-1.05)], lower plateau pressure(Plateau) airway pressure[WMD=-0.29, 95%CI(-0.51,-0.07)] but higher pressure of arterial oxygen[WMD=0.52, 95%CI(0.08, 0.95)] during OLV(T2), and lower Ppeak[WMD=-0.63, 95%CI(-1.09, 0.17)] after chest closing(T3). Conclusions Compared with VCV, PCV results in low airway pressure during OLV, which may be a good ventilation model. Key words: Volume-controlled ventilation; Pressure-controlled ventilation; One-lung ventilation; Respiratory mechanics; Meta-analysis