Effect of pressure-controlled ventilation-volume guaranteed mode combined with individualized positive end-expiratory pressure on respiratory mechanics, oxygenation and lung injury in patients undergoing laparoscopic surgery in Trendelenburg position

The study aimed to investigate the efficacy of PCV-VG combined with individual PEEP during laparoscopic surgery in the Trendelenburg position. 120 patients were randomly divided into four groups: VF group (VCV plus 5cmH(2)O PEEP), PF group (PCV-VG plus 5cmH(2)O PEEP), VI group (VCV plus individual PEEP), and PI group (PCV-VG plus individual PEEP). P-mean, P-peak, Cdyn, PaO2/FiO(2), V-D/V-T, A-aDO(2) and Qs/Qt were recorded at T-1 (15 min after the induction of anesthesia), T-2 (60 min after pneumoperitoneum), and T-3 (5 min at the end of anesthesia). The CC16 and IL-6 were measured at T-1 and T-3. Our results showed that the P-mean was increased in VI and PI group, and the P-peak was lower in PI group at T-2. At T-2 and T-3, the Cdyn of PI group was higher than that in other groups, and PaO2/FiO(2) was increased in PI group compared with VF and VI group. At T-2 and T-3, A-aDO(2) of PI and PF group was reduced than that in other groups. The Qs/Qt was decreased in PI group compared with VF and VI group at T-2 and T-3. At T-2, V-D/V-T in PI group was decreased than other groups. At T-3, the concentration of CC16 in PI group was lower compared with other groups, and IL-6 level of PI group was decreased than that in VF and VI group. In conclusion, the patients who underwent laparoscopic surgery, PCV-VG combined with individual PEEP produced favorable lung mechanics and oxygenation, and thus reducing inflammatory response and lung injury.