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Revista mexicana de anestesiología
versión impresa ISSN 0484-7903
Resumen
CANAS-LUCERO, Lizbeth et al. Comparison of 3 mechanical ventilation modes in laparoscopic cholecystectomy. Rev. mex. anestesiol. [online]. 2021, vol.44, n.3, pp.178-183. Epub 04-Oct-2021. ISSN 0484-7903.
The assisted ventilatory mode during a laparoscopic procedure is still controversial.
Objective:
To compare ventilatory dynamics according to the assisted ventilation mode: by volume-controlled ventilation (VCV), pressure-controlled (PCV) or by pressure with volume guarantee (PVC-VG), in general anesthesia for laparoscopic cholecystectomy.
Material and methods:
21 adult patients managed with one of the three modalities (seven per group). Their respiratory rate, minute expiratory volume, end tidal CO2 (EtCO2), peak airway pressure, mean pulmonary pressure, compliance, oxygen saturation and minute respiratory volume were analyzed during the procedure (at intubation, abdominal CO2 insufflation and resolution).
Results:
After intubation there were no clinical differences in measurements between ventilation modes. On insufflation, patients with PCV mode increased their respiratory rate, but kept their peak pressure; against those in VCV and PCV-VG mode who increased their peak pressure with little reduction in their respiratory rate. The other variables were not modified during the procedure and there were no differences between the ventilatory modes.
Conclusion:
The three modes of ventilation allowed a good ventilatory control, but we suggest the PCV since it prevents an increase in peak pressure.
Palabras llave : Mechanical ventilation; laparoscopic cholecystectomy; ventilatory mode; barotrauma; general anesthesia; atelectasis.