ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1524883
This article is part of the Research TopicAdvances and Challenges in Neonatal Surgery: Congenital and Acquired ConditionsView all 8 articles
Pressure Controlled Ventilation with Volume Guarantee Improves Outcomes in Neonatal Thoracoscopic Esophageal Atresia Surgery
Provisionally accepted
- Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Region, China
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Introduction: Neonatal thoracoscopic repair of esophageal atresia requires one-lung ventilation (OLV), which poses challenges due to immature lung development and low compliance, increasing risks of hypoxemia and barotrauma. While volume-controlled ventilation (VCV) ensures stable tidal volume, it may cause excessive airway pressures, whereas pressure-controlled ventilation (PCV) lacks volume guarantee. This study compared PCV with volume guarantee (PCV-VG) and conventional VCV to improve respiratory outcomes during OLV. Methods: A retrospective analysis was conducted on neonates (aged 1-7 days) undergoing thoracoscopic esophageal atresia repair with OLV. Patients were categorized into PCV-VG and VCV groups. Respiratory parameters (PaO2, PaCO2, airway pressures, dynamic compliance) were measured before, during, and after OLV.Propensity score matching (PSM) was used to balance baseline characteristics.Results: After PSM, 74 neonates (37 per group) were included. During OLV, the PCV-VG group exhibited significantly lower PaCO2, peak/mean airway pressures, and higher dynamic compliance compared to the VCV group (all P<0.05).Postoperatively, PCV-VG was associated with shorter mechanical ventilation duration, ICU stay, and hospital stay (P<0.05). Postoperative complication rates did not differ between groups (P>0.05).PCV-VG offers superior ventilation parameters and faster recovery in neonatal thoracoscopic esophageal atresia repair, though it does not affect postoperative complication rates.
Keywords: Pressure controlled ventilation-volume guaranteed, neonates, Thoracoscopic, Esophageal Atresia, One-Lung Ventilation, postoperative recovery
Received: 18 Feb 2025; Accepted: 30 Apr 2025.
Copyright: © 2025 Lv, Wang, Luo and Luo. 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: Xiaoxia Wang, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Region, China
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