Volume - and pressure - controlled ventilation in surgically intervened patients with chronic respiratory diseases

Abstract

Background: Our scenario presents high frequency of patients with chronic obstructive pulmonary disease and bronchial asthma and who require elective surgery and general anesthesia with volume- and pressure-controlled mechanical ventilation.
Objective: To compare both methods of controlled ventilation in patients with chronic respiratory diseases electively operated at Manuel Ascunce Domenech University Hospital in Camagüey.
Methods: Analytical, observational study. The universe comprised 83 patients and the sample comprised 40 patients. Study group I, in which volume-controlled ventilation was used, and volume was adjusted to 7 mL/kg, with respiratory rate of 10-12 breaths per minute, inspiratory-expiration ratio 1:2, and FiO ₂ at 20.5%; and group II, in which pressure-controlled ventilation was used and the ideal peak inspiratory pressure was set to ensure the patient's adequate volume per minute, respiratory rate of 10-12 breaths per minute, inspiratory-expiration index 1:2, and FiO₂ at 0.5 %. Dynamic compliance was calculated in both groups and the relationship between oxygen arterial pressure and inspired oxygen fraction was determined.
Results: We found higher numbers of the PO₂/FiO₂ ratio, lower PIP numbers and better dynamic compliance in group II.
Conclusions : Pressure-controlled ventilation is a ventilation modality that offers the patient adequate oxygenation with better compliance and control of peak inspiratory pressure.