Comparison of Volume Controlled Ventilation and Pressure Controlled Ventilation in Laparoscopic Bariatric Surgery

Study Overview
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Brief Summary
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The purpose of this study is to compare volume controlled-ventilation (VCV) and pressure-controlled ventilation (PCV) in terms of pulmonary gas exchange, respiratory mechanics and arterial blood gas values in patients undergoing laparoscopic bariatric surgery.

Detailed Description
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Today, morbid obesity has become a global problem. It is not clear which mechanical ventilation mode will be used in bariatric surgery, which is one of the treatment options of these patients. VCV is the most commonly used mode to ventilate anesthetized patients. However, especially in obese patients, high airway pressures and hypoxia may occur due to increased intrapulmonary shunts. Therefore, we aimed to investigate the potential of PCV strategy to improve pulmonary gas exchange, respiratory mechanics and arterial blood gas values according to VCV in patients undergoing bariatric surgery.

Official Title
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Comparison of Volume Controlled Ventilation and Pressure Controlled Ventilation in Terms of Respiratory Mechanics in Laparoscopic Bariatric Surgery

Conditions
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Bariatric Surgery

Intervention / Treatment
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* Procedure: volume-controlled ventilation
* Procedure: pressure-controlled ventilation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years or above, ASA II patients BMI > 40 kg / m2 No serious comorbidity. Exclusion Criteria: Unstable patients during the operation The requirement for mechanical ventilation in the postoperative period.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: volume-controlled ventilation group<br>During the operation, necessary interventions were made by following the algorithm. Hemodynamic and mechanical ventilation parameters of patients were recorded 5 minutes after induction, 30 minutes after pneumoperitoneum and at the end of surgery and were performed arterial blood gas analysis. | Procedure: volume-controlled ventilation<br> <br> |
| Active Comparator: pressure-controlled ventilation group<br>During the operation, necessary interventions were made by following the algorithm. Hemodynamic and mechanical ventilation parameters of patients were recorded 5 minutes after induction, 30 minutes after pneumoperitoneum and at the end of surgery and were performed arterial blood gas analysis. | Procedure: pressure-controlled ventilation<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Partial oxygen pressure | Assessed 5 minutes after induction by using arterial blood gas analysis. | 5 minutes after induction | 
| Partial oxygen pressure | Assessed 30 minutes after pneumoperitoneum by using arterial blood gas | 30 minutes after pneumoperitoneum | 
| Partial oxygen pressure | Assessed through surgery completion, an average of 90 minutes by using arterial blood gas | through surgery completion, an average of 90 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Partial carbon dioxide pressure | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes by using arterial blood gas analysis. | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes | 
| Partial carbon dioxide pressure - end-tidal carbon dioxide pressure | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes by using arterial blood gas analysis and end-tidal monitor. | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes | 
| Peak airway pressure | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes by using the patient monitor. | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes | 
| Dynamic compliance | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes by using formula (Tidal volume/peak airway pressure - Positive end-expiratory pressure) | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes | 
| Inspired oxygen pressure / Fractional oxygen ratio | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes | 
| Alveolar-arterial oxygen gradient pressure | Assessed 5 minutes after induction, 30 minutes after pneumoperitoneum and through surgery completion, an average of 90 minutes by using formula (D(A-a) O2). | 5 minutes after induction, 30 minutes after pneumoperitoneum, through surgery completion, an average of 90 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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bariatric surgery, volume-controlled ventilation, pressure-controlled ventilation