Objective: To investigate the ventilation effect and application safety of pressure-controlled ventilation-volume guaranteed (PCV-VG) mode in neonatal thoracoscopic esophageal atresia surgery.
Methods: Thirty-six newborns who underwent thoracoscopic esophageal atresia surgery under general anesthesia, 22 males and 14 females, aged 1-4 days, weighing 1.4-4.5 kg, ASA physical status Ⅲ or Ⅳ, were divided into two groups using a random number table method: the PCV-VG mode group (group P) and the volume-controlled ventilation (VCV) mode group (group V), 18 newborns in each group. After anesthesia, PCV-VG and VCV ventilation modes were employed for mechanical ventilation in groups P and V, respectively. The MAP, HR, and SpO2 were recorded prior to tracheal intubation, 10 minutes before one-lung ventilation (OLV), 30 minutes after OLV, and 10 minutes after completion of OLV. Additionally, the Pmean, Ppeak, Pplat, Cdyn, PETCO2, PaCO2, PaO2, and pH were monitored 10 minutes before OLV, 30 minutes after OLV, and 10 minutes after completion of OLV. The time of tracheal tube removal after surgery and the duration of ICU retention were also observed.
Results: Compared with group V, the SpO2, Cdyn, PaO2, and pH levels showed a significant increase, while significant decrease were noted in Pmean, Ppeak, and Pplat in group P 30 minutes after OLV (P < 0.05). Compared with group V, the PETCO2 and PaCO2 in group P decreased significantly 30 minutes after OLV and 10 minutes after completion of OLV. Besides, compared with group V, the time of tracheal tube removal after surgery and the duration of ICU retention were also significantly shortened in group P (P < 0.05).
Conclusion: The utilization of PCV-VG ventilation mode in neonatal thoracoscopic esophageal atresia surgery, as compared to VCV ventilation mode, can effectively reduce airway pressure, enhance lung compliance, optimize intraoperative lung gas exchange, and facilitate postoperative recovery of the neonates. |
