Comparison of the effects of volume-controlled ventilation and pressure-controlled ventilation modes on hemodynamics, respiratory mechanics and blood gas parameters in patients undergoing laparoscopic cholecystectomy


  • Ferda Y. Inal Department of Anaesthesiology and Reanimation, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
  • Yadigar Y. Camgoz Clinic of Anaesthesiology and Reanimation, Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey
  • Hayrettin Daskaya Department of Anaesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
  • Oznur Sen Clinic of Anaesthesiology and Reanimation, Haseki Training and Research Hospital, Istanbul, Turkey



Volume-controlled ventilation, Pressure-controlled ventilation, Laparoscopic cholecystectomy


Background: This study aimed to compare the changes induced by VCV and PCV modes in hemodynamics, respiration (airway pressures, gas exchange parameters) and metabolism (acid-base balance) in patients undergoing laparoscopic cholecystectomy.

Methods: Patients were divided into two randomised groups as volume-controlled ventilation (VCV) group (VC) and pressure-controlled ventilation (PCV) group (PC). The following parameters were recorded at 3 different time points: T1: in supine position 10 minutes after induction of anaesthesia, T2: 15 minutes after CO2 insufflation in inverted Trendelenburg position (head 30 degrees up), T3: 10 minutes after CO2 desufflation. HR, SpO2, SAP (systolic arterial pressure), DAP (diastolic arterial pressure), MAP (mean arterial pressure), PetCO2 (end-tidal carbon dioxide pressure), Ppeak, Pplateau, Pmean, Vt (tidal volume) and compliance with the available data, the cases in both groups Vd, Vd/Vt ratios and P(A-a)O2 were calculated. Arterial blood gas parameters (pH, PaO2, PaCO2, SaO2, P(a-et)CO2) values were recorded.

Results: It was found that Ppeak and Pplateau values were significantly higher in the VC group (p<0.05). It was found that compliance was significantly higher in the PC group (p<0.05) (p<0.01). In the postoperative period, it was found that PaO2 values were significantly higher in the PC group compared to the VC group (p<0.05). It was found that the P(A-a)O2 values of the PC group were significantly higher than those of the VC group during the desufflation phase (p<0.05).

Conclusions: We think that PCV mode can be a good alternative for the prevention and correction of physiopathological changes due to laparoscopic surgery.


Peters JH, Ellison CE. Safety and efficacy of laparoscopic cholecystectomy. Ann Surg. 1991;213(1):3-12

Johnson D, Litwin D, Osachoff J, McIntosh D, Bersheid B, Church D, et al. Respiratory function after laparoscopic cholecystectomy. Surg Laparosc Endosc. 1992;2(3):221-6.

Rademaker BM, Ringers J, Odoom JA, Dewit LT, Kalkman CJ, Oosting J. Pulmonary function and stress response after laparoscopic cholecystectomy: comparison with subcostal incision and influence of thoracic epidural analgesia. Anesth Analg. 1992;75(3):381-5.

Joris J, Ledoux D, Honore P, Lamy M. Ventilatory effects of CO2 insufflation during laparoscopic cholecystectomy. Anesthesiology. 1991;75(3):121-5.

Al-Saady N, Bennett ED. Decelerating inspiratory flow waveform improves lung mechanics and gas exchange in patients on intermittent positive-pressure ventilation. Intensive Care Med. 1985;11(2):68-75.

Campbell RS, Davis BR. Pressure-controlled versus volume-controlled ventilation: what is the matter? Respir Care. 2002;47(4):416-24.

Markstrom AM, Lichtwarck-Aschoff M, Svensson BA, et al. Ventilation with constant versus decelerating inspiratory flow in experimentally induced acute respiratory failure. Anesthesiology. 1996;84(4):882-9.

Marini JJ, Ravenscraft SA. Mean airway pressure: physiologic determinants and clinical importance- part 2: clinical implications. Crit Care Med. 1992;20(11):1604-16.

Marco AJ, Yeo CJ. Rock: Anesthesia for the patient undergoing laparoscopic cholecystectomy. Anesthesiology. 1990;73(6):1268-70.

Cunningam AJ, Brul SJ. Laparoscopic cholecystectomy: anaesthetic implications. Anesth Analg. 1993;76(5):1120-33.

Tyagi A, Kumar R, Sethi AK, Mohta M. A comparison of pressure-controlled and volume-controlled ventilation for laparoscopic cholecystectomy. Anaesthesia. 2011;66(6):503-8.

Oğurlu M, Kucuk M, Sızlan A, Yanarateş O, Eksert S, Karaşahin E, et al. Pressure-controlled vs volume-controlled ventilation during laparoscopic gynaecologic surgery J Minim Invasive Gynecol. 2010;17(3):295-300.

Baerdemaeker LE, Herten CVD, Gillardin JM, Pattyn P, Mortier EP, Szegedi LL. Comparison of volume-controlled and pressure-controlled ventilation during laparoscopic gastric banding in morbidly obese patients. Obes Surg. 2008;18(6):680-5.

Cadi P, Guenoun T, Journois D, Chevallier JM, Diehl JL, Safran D. Pressure-controlled ventilation improves oxygenation during laparoscopic obesity surgery compared with volume-controlled ventilation. Br J Anaesth. 2008;100(5):709-16.

Nethra SS, Nagaraja S, Sudheesh K, Duggappa DR, Sanket B. Comparison of effects of volume-controlled and pressure-controlled mode of ventilation on endotracheal cuff pressure and respiratory mechanics in laparoscopic cholecystectomies: A randomised controlled trial. Indian J Anaesth. 2020;64(10):842-8.

Movassagi R, Montazer M, Mahmoodpoor A, Fattahi V, Iranpour A, Sanaie S. Comparison of pressure vs volume-controlled ventilation on oxygenation parameters of obese patients undergoing laparoscopic cholecystectomy. Pak J Med Sci. 2017;33(5):1117-22.

Mihalj M, Vladić D, Karlović Z, Zadro Ž, Majerić Kogler V. Effects of pressure-controlled volume-controlled ventilation on hemodynamic and respiratory parameters in patients during laparoscopic cholecystectomy. Acta Clin Croat. 2017;56(3):555-60.

Wang JP, Wang HB, Liu YJ, Lou XP, Wang XD, Kong Y. Comparison of pressure- and volume-controlled ventilation in laparoscopic surgery: a meta-analysis of randomized controlled trial. Clin Invest Med. 2015;38(3): 119-41.

Ozyurt E, Kavakli AS, Ozturk NK. Comparison of volume-controlled and pressure-controlled ventilation on respiratory mechanics in laparoscopic bariatric surgery: a randomised clinical trial. Braz J Anesthesiol. 2019;69(6):546-52.

Choi S, Yang SY, Choi GJ, Kim BG, Kang H. Comparison of pressure and volume-controlled ventilation during laparoscopic colectomy in patients with colorectal cancer. Sci Rep. 2019;9(1):17007.

Lee JM, Lee SK, Rhim CC, Seo KH, Han M, Kim SY, et al. Comparison of volume-controlled, pressure-controlled, and pressure-controlled volume-guaranteed ventilation during robot-assisted laparoscopic gynaecologic surgery in the Trendelenburg position. Int J Med Sci. 2020;17(17):2728-34.

Balick-Weber CC, Nicolas P, Hedreville-Montout M, Blanchet P, Ste'phan F. Respiratory and haemodynamic effects of volume-controlled vs pressure-controlled ventilation during laparoscopy: a cross-over study with echocardiographic assessment. Br J Anaesth. 2007;99:429-35.






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