COMPARATIVE STUDY OF PRESSURE-CONTROLLED VENTILATION VS. VOLUME-CONTROLLED VENTILATION IN ROBOTIC-ASSISTED NEPHRECTOMIES: EFFECTS ON RESPIRATORY MECHANICS AND HEMODYNAMICS

Introduction: Robotic-assisted nephrectomies require effective ventilation strategies due to pneumoperitoneum and Trendelenburg positioning, which significantly affect respiratory mechanics and hemodynamics. Objective: To compare the effect of pressure-controlled ventilation (PCV) with that of volume-controlled ventilation (VCV) on the intraoperative respiration and hemodynamic values during robotic-assisted nephrectomies. Material and Method: The randomised controlled trial was done between June 2024 and November 2024 at the Sindh Institute of Urology and Transplantation. Sixty patients were randomised into two groups (PCV and VCV, n=30 each). Peak inspiratory pressure (PIP), plateau pressure (Pplat), SpO, etCO, heart rate (HR) and mean blood pressure (MBP) were measured using four time points. Results: The values of PIP and Pplat were substantially reduced during PCV than VCV, with a p value of <0.05. The PCV group was more hemodynamically stable, especially MBP. The two groups demonstrated similar oxygenation and CO 2 clearance. Conclusion: PCV offers better airway pressure management and hemodynamic stability compared to VCV, making it preferred for robotic nephrectomies.