CLINICAL TRIAL article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1647682
This article is part of the Research TopicAdvancements in Mechanical Ventilation: Understanding Physiology to Mitigate ComplicationsView all 10 articles
Effects of Pressure-Controlled Ventilation-Volume Guaranteed on children undergoing thoracic surgery: a prospective, randomized controlled trial
Provisionally accepted
- The Affiliated Children's Hospital of Central South University Xiangya School of Medicine, Changsha, China
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Background: Children have higher morbidity and mortality than adults during thoracic surgery with one-lung ventilation (OLV)，reducing the incidence may in part be achieved by the use of appropriate mechanical ventilation mode. This study evaluated whether pressure-controlled ventilation-volume guaranteed (PCV-VG) reduces intrapulmonary shunt (Qs/Qt) and ventilator-induced lung injury (VILI) in pediatric patients.Methods: Eighty children underwent thoracic surgery requiring OLV were randomly divided into PCV-VG group and volume-controlled ventilation (VCV) group. The PCV-VG group utilized the PCV-VG during surgery, whereas the other group employed the VCV. The parameter settings during two-lung and OLV were consistent between the groups. The primary outcome comprised the Qs/Qt fraction. The secondary outcomes encompassed respiratory parameters, blood gas analysis results, the occurrence of postoperative pulmonary complications (PPCs), and more.Results: Following PCV-VG implementation, the median Qs/Qt during OLV exhibited a significant improvement (18.2 to 12.7 at T2, 11.4 to 9.1 at T3, P < 0.0001).Additionally, compared with VCV , PCV-VG improved oxygenation during OLV (higher PaO2, PaO2/FiO2, and other oxygenation indices), reduced airway pressure during OLV (25cmH2O to 20cmH2O at T2, P < 0.0001), and lowered the incidence of PPCs (38.5% to 7.3%, adjusted odds ratio [OR] 0.13, 95% confidence interval [CI]: 0.03-0.50, P = 0.001), shortened the duration of postoperative mechanical ventilation (120min to 110min, difference [95% CI], 20 [0 to 40], P = 0.036). Conclusion: Implementation of PCV-VG for children undergoing thoracic surgery demonstrated significant benefits. It can improve Qs/Qt, increase oxygenation, reduce airway pressure, and alleviate VILI during OLV.
Keywords: Pressure-controlled ventilation-volume guaranteed, One-Lung Ventilation, Children, Intrapulmonary shunt, Video-assisted thoracoscopic surgery, Ventilatorinduced lung injury
Received: 16 Jun 2025; Accepted: 22 Aug 2025.
Copyright: © 2025 Wang, Zhu, Zhu, Yan, Du, Xiao and Qu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ting Xiao, The Affiliated Children's Hospital of Central South University Xiangya School of Medicine, Changsha, China
Shuangquan Qu, The Affiliated Children's Hospital of Central South University Xiangya School of Medicine, Changsha, China
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