Respiratory ventilation modes in selective ophthalmic arterial chemotherapy for pediatric retinoblastoma under general anesthesia.

OBJECTIVE

To determine the optimal ventilation strategy for pediatric patients with retinoblastoma undergoing selective ophthalmic arterial chemotherapy (SOAC) by comparing the intraoperative effects of volume-controlled (VCV), pressure-controlled (PCV), and pressure-controlled volume-guaranteed (PCV-VG) ventilation.

METHODS

105 children (aged 1.5-5 years) undergoing SOAC were assigned to three groups: VCV (n = 33), PCV (n = 37), and PCV-VG (n = 35). Hemodynamics, airway pressures, end-expiratory carbon dioxide (EtCO2), arterial blood gases, and clinical complications were recorded and analyzed.

RESULTS

Postoperatively, the peak airway pressure in Group V was significantly higher than those in Group P and Group G. The EtCO2 of Group P was closer to normal values than that of the other two groups during surgery p < 0.05. Blood gas results at the three-time points showed that pH and HCO3 - values of Group P were closer to normal than those of the other two groups immediately after the operation and 5 minutes after the end of angiography, respectively p < 0.05. No significant differences of other indicators were found among the three groups.

CONCLUSION

Altogether, compared with the VCV, both PCV and PCV-VG modes produced beneficial lower peak airway pressures during SOAC, thus conducing to prevent mechanical ventilation lung injury.