Effect of pressure-controlled ventilation-volume guaranteed model on respiratory function in pneumoconiosis patients undergoing whole-lung lavage

Objective To explore the effect of pressure-controlled ventilation-volume guaranteed （PCV-VG） mode on the respiratory function of patients undergoing whole-lung lavage （WLL） for pneumoconiosis.

Methods Pneumoconiosis patients who underwent WLL from September 2019 to September 2023 were divided into two groups according to the ventilation mode used during original treatment, the PCV-VG or the volume-controlled ventilation （VCV）, with a total of 30 patients in each group randomly selected by random number table method. Patients in the two groups were subjected to whole-lung lavage and resuscitated under one-lung PCV-VG and VCV mode mechanical ventilation, respectively. Their medical records of radial artery blood gas analysis, including partial pressure of oxygen （PaO₂）, partial pressure of carbon dioxide （PaCO₂）, alveolar-arterial oxygen pressure difference （PA-aDO₂）, and lactate （LAC）, were collected at admission （T₀）, before lavage （T₁）, at the end of lavage （T₂）, 30 minutes after early resuscitation （T₃）, 60 minutes after late resuscitation （T₄）, 24 hours post-operation （T₅）, 48 hours post-operation （T₆）, and 72 hours post-operation （T₇）. Additionally, the indicators of respiratory function, such as peak airway pressure （P_peak）, plateau pressure （P_plat）, dynamic lung compliance （C_ldyn）, and driving pressure （DP）, were recorded at T₁, T₂, T₃, and T₄ points in time. The differences of each observation index were analyzed and compared.

Results There were no statistically significant differences between the two groups in terms of age, BMI, and pneumoconiosis stage （all P > 0.05）. Comparison of blood gas analysis results between the PCV-VG group and the VCV group: at T₁, no statistically significant differences （P > 0.05）; at T₂, PaCO₂ was lower in the PCV-VG group than in the VCV group （P < 0.05）; at T₃, PaO₂ was higher, and PaCO₂ was lower in the PCV-VG group than in the VCV group （both P < 0.05）; at T₄, PaO₂ was higher, and PaCO₂, PA-aDO₂, and LAC were lower in the PCV-VG group （all P < 0.05）; at T₆, PA-aDO₂ and LAC were lower in the PCV-VG group （both P < 0.05）; at T₇, PaCO₂ was lower in the PCV-VG group （P < 0.05）. At T₁, the differences between the respiratory mechanics parameter indexes of the two groups were not statistically significant （all P > 0.05）; at T₂, T₃, and T₄, P_peak and P_plat were lower （both P < 0.01）, and C_ldyn was higher （P < 0.05） in the PCV-VG group than in the VCV group; at T₃, DP was lower in the PCV-VG group （P < 0.01）.

Conclusions Compared with the VCV mode, the PCV-VG mode could reduce airway pressure and ventilator driving pressure, improve lung compliance, maintain good oxygen supply, and protect the respiratory function of patients.