RT Journal Article
SR Electronic
T1 Individualized flow controlled ventilation compared to pressure controlled ventilation in one lung ventilation – a prospective, randomized porcine study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1717
DO 10.1183/13993003.congress-2020.1717
VO 56
IS suppl 64
A1 Spraider, Patrick
A1 Abram, Julia
A1 Ranalter, Manuela
A1 Mathis, Simon
A1 Putzer, Gabriel
A1 Martini, Judith
YR 2020
UL https://publications.ersnet.org//content/56/suppl_64/1717.abstract
AB Background: Flow controlled ventilation (FCV) is a novel ventilation method established to guarantee a continuous stable flow during in- and expiration. Additionally, in FCV direct intratracheal pressure measurement allows to determine lung mechanic limits and therefore individually optimize ventilation.Aims and Objectives: Aim of this study was to investigate individualized FCV compared to pressure controlled ventilation (PCV) in a porcine model of simulated thoracic surgery requiring one lung ventilation (OLV).Methods: Thoracic surgery was simulated with left sided thoracotomy and collapse of the left lung over a period of 3 hours. Ventilation was performed with compliance guided pressure settings in FCV. PCV was established with compliance guided PEEP setting and peak pressure set to achieve a tidal volume of 6 ml/kg during OLV.Results: The FCV group (n=8) maintained normocapnia despite a significantly lower respiratory minute volume (8.0 vs. 11.6 l/min, p<0.001) compared to the PCV group (n=8), where permissive hypercapnia had to be accepted during OLV (paCO2 42.6 vs. 51.7 mmHg, p<0.001). Tidal volume (6.11 vs. 6.09 ml/kg, p=0.840) and Horowitz index (333.7 vs. 313.8, p=0.186) were comparable in both groups as well as pulmonary shunt fraction (5.0 vs. 6.8 %, p=0.131) during OLV.Conclusion: In this porcine study individualized FCV maintained normocapnia during OLV within a significant reduction of respiratory minute volume, while permissive hypercapnia had to be accepted in PCV. We hypothesize this finding is due to active control of expiratory flow in FCV, which is a novelty in artificial ventilation.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1717.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).