EFFECT OF PRESSURE-REGULATED VOLUME CONTROL VERSUS PRESSURE-CONTROL VENTILATION ON ARTERIAL BLOOD GAS PARAMETERS IN PEDIATRIC PATIENTS UNDERGOING ELECTIVE SURGERIES

Abstract

Background: Ventilation mode selection is important in pediatric laparoscopic surgery, where pneumoperitoneum alters respiratory mechanics. This study compared pressure-regulated volume control (PRVC) and pressure-controlled ventilation (PCV) on arterial blood gas parameters and airway pressures in children undergoing elective laparoscopic surgery.

Objective: To compare the effects of Pressure-Regulated Volume Control (PRVC) and Pressure-Controlled Ventilation (PCV) on arterial blood gas (ABG) parameters in pediatric patients undergoing elective surgeries under general anesthesia.

Methods: In this six-month comparative cross-sectional study conducted in Lahore, Pakistan, 80 children aged 2–12 years (ASA I–II) were allocated equally to PRVC or PCV groups. Blood gases and airway pressures were measured after induction and after pneumoperitoneum.

Results: PRVC showed lower peak (16 vs. 18 cmH₂O, p=0.020) and mean airway pressure (8 vs. 11.5 cmH₂O, p=0.002) than PCV. After induction, PaO₂ (180 vs. 122 mmHg, p=0.005) and PaO₂/FiO₂ ratio (330 vs. 240, p=0.005) were higher with PRVC, with modestly higher PaCO₂ and PETCO₂ (p<0.001); pH was similar (p=0.984). Post-pneumoperitoneum, PaO₂ (p=0.007) and PaO₂/FiO₂ ratio (p=0.004) remained higher with PRVC, while pH and HCO₃⁻ did not differ. The rise in PaO₂ from baseline was greater with PRVC (p=0.041), and the rise in ETCO₂ was smaller (p=0.003).

Conclusion: PRVC is a lung-protective ventilation strategy that can be used in pediatric laparoscopic surgery, as it allows for lower airway pressures and better oxygenation without compromising CO₂ clearance when compared to PCV.