Lung ultrasound score-based perioperative assessment of pressure-controlled ventilation-volume guaranteed or volume-controlled ventilation in geriatrics: a prospective randomized controlled trial

Figures & data

Table 1 Demographic data

	Group PCV-VG (n=40)	Group VCV (n=36)
Age (years)	77.35±5.99	78.97±5.95
Sex (M/F)	11/29	8/28
Weight (kg)	57.87±8.37	54.49±10.16
Height (cm)	156.04±7.73	155.93±8.66
Charlson comorbidity Index(0/1/2/≥3)	11/14/5/8	7/16/3/9

Note: Values are either the mean ± SD or the number of patients.

Abbreviations: PCV-VG, pressure-controlled ventilation-volume guaranteed; VCV, volume-controlled ventilation.

Table 2 Perioperative outcomes and recovery profiles

	Group PCV-VG (n=40)	Group VCV (n=36)
ANE time (min)	163.25±54.86	147.08±56.83
OP position (RLD/LLD)	23/17	16/20
Transfusion (Y/N)	10/30	7/29
- RBC (pack)	0.22±0.50	0.23±0.57
- FFP (pack)	0.06±0.32	0.09±0.37
Colloid use (Y/N)	1/39	1/35
Total fluid (mL)	704.00±425.22	624.44±356.63
Blood loss (mL)	293.50±364.94	248.33±317.95
Urine output (mL)	340.63±277.68	312.50±235.68
Fentanyl use in PACU (mcg)	95.43±42.71	101.67±35.05
VNRS in PACU at 1 hr	3.48±1.92	3.33±1.12
RASS in PACU at 1 hr	0.00±0.72	−0.03±0.45
CAM-ICU in PACU at 1 hr (positive/negative)	7/33	3/33
FEV1 (pre/postoperative)	1.74±0.48/1.47±0.43^a	1.65±0.44/1.35±0.40^a
FVC (pre/postoperative)	2.44±0.68/2.06±0.65^a	2.26±0.61/1.79±0.61^a

Notes: Values are mean ± SD or number of patients. ^ap<0.05 compared to the preoperative value.

Abbreviations: PCV-VG, pressure-controlled ventilation-volume guaranteed; VCV, volume-controlled ventilation; RLD, Right lateral decubitus; LLD, Left lateral decubitus; PACU, post-anesthesia care unit; VNRS, verbal numeric rating scale; RASS, the Richmond agitation and sedation scale; CAM-ICU, confusion assessment method for the ICU; FEV₁, forced expiratory volume at timed intervals of 1.0 seconds; FVC, forced vital capacity.

Figure 1 Flow diagram.

Abbreviations: PCV-VG, pressure-controlled ventilation-volume guaranteed; VCV, volume-controlled ventilation.

Table 3 Changes in respiratory parameters during surgery

	Group PCV-VG (n=40)	Group VCV (n=36)
PIP – Preoperative	17.98±2.27	20.39±2.56^a
- Decubitus position	19.63±2.67	22.33±2.58^a
- Before awakening	18.93±2.67	21.19±2.75^a
PP – Preoperative	17.98±2.27	18.06±2.33
- Decubitus position	19.48±3.04	19.92±2.12
- Before awakening	18.77±2.89	18.64±2.75
PaCO2 – Preoperative	36.38±4.43	35.44±3.61
- Decubitus position	34.73±3.35	35.22±3.43
- Before awakening	35.60±3.66	35.56±3.88
PaO2 – Preoperative	212.04±29.93	202.78±37.39
- Decubitus position	205.10±32.35	194.81±42.96
- Before awakening	202.80±33.13	194.19±40.18
Cdyn - Preoperative	35.70±7.22	28.95±5.64^a
- Decubitus position	31.99±7.00	25.62±4.25^a
- Before awakening	33.54±7.23	27.36±5.90^a
Cstat – Preoperative	35.70±7.22	34.34±7.49
- Decubitus position	33.48±13.00	29.81±5.44
- Before awakening	34.19±8.07	33.00±8.75
DS – Preoperative	0.15±0.07	0.15±0.08
- Decubitus position	0.16±0.08	0.16±0.08
- Before awakening	0.17±0.09	0.19±0.09

Notes: Values are mean ± SD. ^ap<0.05 compared to the PCV-VG group.

Abbreviations: PIP, peak inspiratory pressure; PP, plateau pressure; P_aCO₂, partial pressure of carbon dioxide; PaO₂, partial pressure of arterial oxygen; Cdyn, dynamic compliance; Cstat, static compliance; DS, alveolar dead space; PCV-VG, pressure-controlled ventilation-volume guaranteed; VCV, volume-controlled ventilation.

Figure 2 Changes in LUS in the PCV-VG or VCV group.

Note: There were significant effects on LUS observed in the PCV-VG or VCV group (using repeated measures ANOVA). LUS, lung ultrasound score. *P<0.0083 (considering Bonferroni correction) compared to the preoperative value.

Figure 3 Visual model of LUS results.

Note: An LUS value of 0.5 or less was set to white and a value of 1.5 or more was set to black. Between 0.5 and 1.5, when the LUS value was closer to 0.5, the color was brighter, and when it was closer to 1.5, the color was darker. Therefore, a brighter color means a lower LUS, which is preferable.
Abbreviation: LUS, lung ultrasound score.