Effect of PCV and VCV on Extravascular Lung Water

The Ultrasound Estimation of Extravascular Lung Water in Volume Controlled Versus Pressure Controlled Ventilation After One Lung Ventilation in Thoracoscopic Surgery. A Comparative Study

Volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) are the common ventilatory modes during OLV undergoing thoracic surgery. A controversy regarding which ventilation mode is better for oxygenation during OLV with PCV enhances oxygenation more than VCV ;given its initial high peak inspiratory flow rates and its rapidly decelerating flow pattern. However, this high peak inspiratory flow rate might also provoke lung injury via shearing and traction forces on the alveoli. Extravascular lung water describes water within the lungs but outside pulmonary vasculature. Lung ultrasound (LUS) assessment of EVLW by B-lines provides a reliable and easy alternative.

Inclusion Criteria:

• Adult patients aged (18-60 years), undergoing elective thoracoscopic surgery with one lung ventilation

Exclusion Criteria:

• Emergency surgeries.
• Left Ventricular ejection fraction less than 40%.
• Any patient known to have pulmonary hypertension
• Patients with preoperative congestive heart failure, cardiogenic shock, preoperative pulmonary edema
• Hepatic patients (liver functions double the upper reference range)
• Morbid obesity (BMI > 40).
• Renally impaired patients with creatinine more than 2 mg/dl.
• Any patient with respiratory dysfunction (FEV1<60% of the expected).
• Any patient with previous thoracic surgery.
• One lung ventilation more than 2 hours