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The purpose of this study is to compare volume controlled-ventilation (VCV) and pressure-controlled ventilation (PCV) in terms of pulmonary gas exchange, respiratory mechanics and arterial blood gas values in patients undergoing laparoscopic bariatric surgery.
Today, morbid obesity has become a global problem. It is not clear which mechanical ventilation mode will be used in bariatric surgery, which is one of the treatment options of these patients. VCV is the most commonly used mode to ventilate anesthetized patients. However, especially in obese patients, high airway pressures and hypoxia may occur due to increased intrapulmonary shunts. Therefore, we aimed to investigate the potential of PCV strategy to improve pulmonary gas exchange, respiratory mechanics and arterial blood gas values according to VCV in patients undergoing bariatric surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| volume-controlled ventilation group | Active Comparator | During the operation, necessary interventions were made by following the algorithm. Hemodynamic and mechanical ventilation parameters of patients were recorded 5 minutes after induction, 30 minutes after pneumoperitoneum and at the end of surgery and were performed arterial blood gas analysis. |
|
| pressure-controlled ventilation group | Active Comparator | During the operation, necessary interventions were made by following the algorithm. Hemodynamic and mechanical ventilation parameters of patients were recorded 5 minutes after induction, 30 minutes after pneumoperitoneum and at the end of surgery and were performed arterial blood gas analysis. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| volume-controlled ventilation | Procedure |
| ||
| pressure-controlled ventilation |
| Measure | Description | Time Frame |
|---|---|---|
| Partial oxygen pressure | Assessed 5 minutes after induction by using arterial blood gas analysis. | 5 minutes after induction |
| Partial oxygen pressure | Assessed 30 minutes after pneumoperitoneum by using arterial blood gas | 30 minutes after pneumoperitoneum |
| Partial oxygen pressure | Assessed through surgery completion, an average of 90 minutes by using arterial blood gas | through surgery completion, an average of 90 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Partial carbon dioxide pressure | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes by using arterial blood gas analysis. | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Erhan Ozyurt, MD | Antalya Training and Research Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Antalya Traning and Research Hospital | Antalya | Turkey (Türkiye) |
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| Procedure |
|
| Partial carbon dioxide pressure - end-tidal carbon dioxide pressure |
Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes by using arterial blood gas analysis and end-tidal monitor. |
| 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes |
| Peak airway pressure | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes by using the patient monitor. | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes |
| Dynamic compliance | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes by using formula (Tidal volume/peak airway pressure - Positive end-expiratory pressure) | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes |
| Inspired oxygen pressure / Fractional oxygen ratio | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes |
| Alveolar-arterial oxygen gradient pressure | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes by using formula (D(A-a) O2). | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes |