COMPARATIVE STUDY OF PRESSURE-CONTROLLED VENTILATION VS. VOLUME-CONTROLLED VENTILATION IN ROBOTIC-ASSISTED NEPHRECTOMIES: EFFECTS ON RESPIRATORY MECHANICS AND HEMODYNAMICS
Main Article Content
Keywords
Pressure-controlled ventilation, Volume-controlled ventilation, Robotic nephrectomy,
Abstract
Introduction: Robotic-assisted nephrectomies require effective ventilation strategies due to pneumoperitoneum and Trendelenburg positioning, which significantly affect respiratory mechanics and hemodynamics.
Objective: To compare the effect of pressure-controlled ventilation (PCV) with that of volume-controlled ventilation (VCV) on the intraoperative respiration and hemodynamic values during robotic-assisted nephrectomies.
Material and Method: The randomised controlled trial was done between June 2024 and November 2024 at the Sindh Institute of Urology and Transplantation. Sixty patients were randomised into two groups (PCV and VCV, n=30 each). Peak inspiratory pressure (PIP), plateau pressure (Pplat), SpO, etCO, heart rate (HR) and mean blood pressure (MBP) were measured using four time points.
Results: The values of PIP and Pplat were substantially reduced during PCV than VCV, with a p value of <0.05. The PCV group was more hemodynamically stable, especially MBP. The two groups demonstrated similar oxygenation and CO 2 clearance.
Conclusion: PCV offers better airway pressure management and hemodynamic stability compared to VCV, making it preferred for robotic nephrectomies.
References
2- Khater N, Morris AG, Vanvalkenburg DM, Garcia AJ, Jin K, Ahmadzadeh S, Shekoohi S, Cornett EM, Kaye AD. Clinical considerations and outcomes of robotic urologic surgery in obese patients. Turkish Journal of Anaesthesiology and Reanimation. 2024 May 3;52(2):39.
3- Lambertini L, Pacini M, Polverino P, Wilkinson NR, Calvo RS, Cannoletta D, Pellegrino AA, Pettenuzzo G, Di Maida F, Mari A, Bignante G. The Anesthesiologic Impact of Single-Port Robot-Assisted Partial Nephrectomy: A Tertiary Referral Comparative Analysis Between Full-Flank Transperitoneal, Retroperitoneal, and Supine Lower Anterior Access (LAA). Journal of Personalized Medicine. 2025 Jul;15(7):306.
4- Schick V, Dusse F, Eckardt R, Kerkhoff S, Commotio S, Hinkelbein J, Mathes A. Comparison of volume-guaranteed or-targeted, pressure-controlled ventilation with volume-controlled ventilation during elective surgery: a systematic review and meta-analysis. Journal of clinical medicine. 2021 Mar 19;10(6):1276.
5- Chowdhury S, Maiti AK, Chattopadhyay S, Bhar D. Volume-Controlled, Pressure-Controlled vs. Pressure-Controlled Volume-Guaranteed Ventilations in Improving Respiratory Dynamics During Laparoscopic Cholecystectomy: A Prospective, Randomized, Comparative Study. Bali Journal of Anesthesiology. 2023 Jan 1;7(1):13-8.
6- Rietveld PJ, Snoep JW, Lamping M, van der Velde F, de Jonge E, van Westerloo DW, Schoe A. Mechanical power differs between pressure-controlled ventilation and different volume-controlled ventilation modes. Critical care explorations. 2022 Aug 1;4(8):e0741.
7- Dhakshinamurthy DP, Singam DA. Comparative study of the efficacy of volume control ventilation vs pressure control ventilation on patients undergoing laparoscopic surgeries under general anaesthesia. F1000Research. 2024 Jun 24;13:678.
8- Ammar AA, Abdelkader AZ, Elhady SM, Yacout AG. Comparative study between the effect of volume-controlled ventilation and pressure controlled ventilation volume guaranteed on gas exchange and respiratory dynamics during one-lung ventilation. Egyptian Journal of Anaesthesia. 2021 Jan 1;37(1):248-55.
9- Soliman AM, Taha SS, El Agamy AE, El Seidy MI, Youssef AM. Comparative study of the effects of volume-controlled ventilation vs. pressure-controlled volume guaranteed ventilation in patients with obesity during laparoscopic surgery. Anaesthesia, Pain & Intensive Care. 2025 Apr 4;29(2):318-24.
10- Fuest K, Dorfhuber F, Lorenz M, von Dincklage F, Mörgeli R, Kuhn KF, Jungwirth B, Kanz KG, Blobner M, Schaller SJ. Comparison of volume-controlled, pressure-controlled, and chest compression-induced ventilation during cardiopulmonary resuscitation with an automated mechanical chest compression device: A randomized clinical pilot study. Resuscitation. 2021 Sep 1;166:85-92.
11- Takaoka K, Toma S, Lee P, Daoud EG. A comparative analysis of mechanical power and Its components in pressure-controlled ventilation mode and AVM-2 mode. J Mech Vent. 2023;4(4):130-40.
12- Han J, Hu Y, Liu S, Hu Z, Liu W, Wang H. Volume-controlled ventilation versus pressure-controlled ventilation during spine surgery in the prone position: A meta-analysis. Annals of Medicine and Surgery. 2022 Jun 1;78:103878.
13- Nasrolahzadeh S, Nourian J, Khosravi A, Ghasempour S, Abbasi A, Ebrahimi H. Comparison of the effect of pressure control and volume control ventilation on endotracheal tube cuff pressure in patients undergoing general anesthesia and mechanical ventilation: a parallel randomized clinical trial. BMC anesthesiology. 2023 Sep 5;23(1):300.
14- Wang YP, Wei Y, Chen XY, Zhang LX, Zhou M, Wang J. Comparison between pressure-controlled ventilation with volume-guaranteed mode and volume-controlled mode in one-lung ventilation in infants undergoing video-assisted thoracoscopic surgery. Translational Pediatrics. 2021 Oct;10(10):2514.
15- Wang P, Zhao S, Gao Z, Hu J, Lu Y, Chen J. Use of volume controlled vs. pressure controlled volume guaranteed ventilation in elderly patients undergoing laparoscopic surgery with laryngeal mask airway. BMC anesthesiology. 2021 Mar 8;21(1):69.
16- Hasan IF, Haider HS. Comparison Between Volume Controlled Ventilation and Pressure Controlled Ventilation in Laparoscopic Cholecystectomy and their Effects on Hemodynamic and Respiratory Parameters. Med Legal Update.. 2023 Jan;23(1):7-14.
17- Sevdi MS, Demirgan S, Erkalp K, Erol MK, Ozalp A, Altinel Y, Alagol A. Comparison of intra-operative pressure-controlled ventilation and volume-controlled ventilation in bariatric surgery: a prospective randomized study. Cureus. 2021 Aug 30;13(8).
18- Pournajafian A, Sakhaeyan E, Rokhtabnak F, Alimian M, Ghodrati A, Jolousi M, Ghodraty MR. Comparison of pressure and volume-controlled mechanical ventilation in laparoscopic bariatric surgery: a randomized crossover trial. Anesthesiology and Pain Medicine. 2022 Apr 27;12(2):e123270.
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Sagar Khurana
Department of Anaesthesia, Sindh Institute of Urology and Transplantation Karachi, Pakistan
Vijai Kumar
Department of Anaesthesia, Sindh Institute of Urology and Transplantation Karachi, Pakistan
Shakil Malik
Department of Anaesthesia, Sindh Institute of Urology and Transplantation Karachi, Pakistan
Zamir Ahmad
Department of Anaesthesia, Sindh Institute of Urology and Transplantation Karachi, Pakistan
Syed Muhammed Abbas
Department of Anaesthesia, Sindh Institute of Urology and Transplantation Karachi, Pakistan
Qamar Abbas
Department of Anaesthesia, Sindh Institute of Urology and Transplantation Karachi, Pakistan