Changes in dead space components during pressure-controlled inverse ratio ventilation: A secondary analysis of a randomized trial.

<h4>Background</h4>We previously reported that there were no differences between the lung-protective actions of pressure-controlled inverse ratio ventilation and volume control ventilation based on the changes in serum cytokine levels. Dead space represents a ventilation-perfusion mismat...

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Autores principales:	Go Hirabayashi, Yuuki Yokose, Kohei Nagata, Hiroyuki Oshika, Minami Saito, Yuki Akihisa, Koichi Maruyama, Tomio Andoh
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8fb7f7aaa56e4d588a132ab9b8df3299
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spelling	oai:doaj.org-article:8fb7f7aaa56e4d588a132ab9b8df32992021-12-02T20:19:16ZChanges in dead space components during pressure-controlled inverse ratio ventilation: A secondary analysis of a randomized trial.1932-620310.1371/journal.pone.0258504https://doaj.org/article/8fb7f7aaa56e4d588a132ab9b8df32992021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258504https://doaj.org/toc/1932-6203<h4>Background</h4>We previously reported that there were no differences between the lung-protective actions of pressure-controlled inverse ratio ventilation and volume control ventilation based on the changes in serum cytokine levels. Dead space represents a ventilation-perfusion mismatch, and can enable us to understand the heterogeneity and elapsed time changes in ventilation-perfusion mismatch.<h4>Methods</h4>This study was a secondary analysis of a randomized controlled trial of patients who underwent robot-assisted laparoscopic radical prostatectomy. The inspiratory to expiratory ratio was adjusted individually by observing the expiratory flow-time wave in the pressure-controlled inverse ratio ventilation group (n = 14) and was set to 1:2 in the volume-control ventilation group (n = 13). Using volumetric capnography, the physiological dead space was divided into three dead space components: airway, alveolar, and shunt dead space. The influence of pressure-controlled inverse ratio ventilation and time factor on the changes in each dead space component rate was analyzed using the Mann-Whitney U test and Wilcoxon's signed rank test.<h4>Results</h4>The physiological dead space and shunt dead space rate were decreased in the pressure-controlled inverse ratio ventilation group compared with those in the volume control ventilation group (p < 0.001 and p = 0.003, respectively), and both dead space rates increased with time in both groups. The airway dead space rate increased with time, but the difference between the groups was not significant. There were no significant changes in the alveolar dead space rate.<h4>Conclusions</h4>Pressure-controlled inverse ratio ventilation reduced the physiological dead space rate, suggesting an improvement in the total ventilation/perfusion mismatch due to improved inflation of the alveoli affected by heterogeneous expansion disorder without hyperinflation of the normal alveoli. However, the shunt dead space rate increased with time, suggesting that atelectasis developed with time in both groups.Go HirabayashiYuuki YokoseKohei NagataHiroyuki OshikaMinami SaitoYuki AkihisaKoichi MaruyamaTomio AndohPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258504 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Go Hirabayashi Yuuki Yokose Kohei Nagata Hiroyuki Oshika Minami Saito Yuki Akihisa Koichi Maruyama Tomio Andoh Changes in dead space components during pressure-controlled inverse ratio ventilation: A secondary analysis of a randomized trial.
description	<h4>Background</h4>We previously reported that there were no differences between the lung-protective actions of pressure-controlled inverse ratio ventilation and volume control ventilation based on the changes in serum cytokine levels. Dead space represents a ventilation-perfusion mismatch, and can enable us to understand the heterogeneity and elapsed time changes in ventilation-perfusion mismatch.<h4>Methods</h4>This study was a secondary analysis of a randomized controlled trial of patients who underwent robot-assisted laparoscopic radical prostatectomy. The inspiratory to expiratory ratio was adjusted individually by observing the expiratory flow-time wave in the pressure-controlled inverse ratio ventilation group (n = 14) and was set to 1:2 in the volume-control ventilation group (n = 13). Using volumetric capnography, the physiological dead space was divided into three dead space components: airway, alveolar, and shunt dead space. The influence of pressure-controlled inverse ratio ventilation and time factor on the changes in each dead space component rate was analyzed using the Mann-Whitney U test and Wilcoxon's signed rank test.<h4>Results</h4>The physiological dead space and shunt dead space rate were decreased in the pressure-controlled inverse ratio ventilation group compared with those in the volume control ventilation group (p < 0.001 and p = 0.003, respectively), and both dead space rates increased with time in both groups. The airway dead space rate increased with time, but the difference between the groups was not significant. There were no significant changes in the alveolar dead space rate.<h4>Conclusions</h4>Pressure-controlled inverse ratio ventilation reduced the physiological dead space rate, suggesting an improvement in the total ventilation/perfusion mismatch due to improved inflation of the alveoli affected by heterogeneous expansion disorder without hyperinflation of the normal alveoli. However, the shunt dead space rate increased with time, suggesting that atelectasis developed with time in both groups.
format	article
author	Go Hirabayashi Yuuki Yokose Kohei Nagata Hiroyuki Oshika Minami Saito Yuki Akihisa Koichi Maruyama Tomio Andoh
author_facet	Go Hirabayashi Yuuki Yokose Kohei Nagata Hiroyuki Oshika Minami Saito Yuki Akihisa Koichi Maruyama Tomio Andoh
author_sort	Go Hirabayashi
title	Changes in dead space components during pressure-controlled inverse ratio ventilation: A secondary analysis of a randomized trial.
title_short	Changes in dead space components during pressure-controlled inverse ratio ventilation: A secondary analysis of a randomized trial.
title_full	Changes in dead space components during pressure-controlled inverse ratio ventilation: A secondary analysis of a randomized trial.
title_fullStr	Changes in dead space components during pressure-controlled inverse ratio ventilation: A secondary analysis of a randomized trial.
title_full_unstemmed	Changes in dead space components during pressure-controlled inverse ratio ventilation: A secondary analysis of a randomized trial.
title_sort	changes in dead space components during pressure-controlled inverse ratio ventilation: a secondary analysis of a randomized trial.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/8fb7f7aaa56e4d588a132ab9b8df3299
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Changes in dead space components during pressure-controlled inverse ratio ventilation: A secondary analysis of a randomized trial.

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