Comparison of the effect of two variable intraoperative ventilation on perioperative pulmonary complications assessed by lung ultrasonography in patients undergoing laparoscopic abdominal surgery

Background: General anesthesia can cause respiratory complications like atelectasis, even in non-obese patients. Lung ultrasonography (LUS) is an effective tool for detecting and monitoring atelectasis. Mechanical ventilation strategies play a crucial role in maintaining oxygenation during surgery.Objectives: To evaluate the effect of volume-controlled (VCV) and pressure-controlled volume guaranteed (PCV-VG) ventilation on intraoperative and postoperative pulmonary atelectasis using lung ultrasonography.Patients and methods: This prospective randomized controlled study was conducted on 60 patients (age 18-70, American Society of Anesthesiologists (ASA) I-II) scheduled for laparoscopic surgery. Patients were randomized into two groups: VCV and PCV-VG. LUS was performed at four time points to assess aeration loss, with a scoring system from 0 (normal) to 3 (severe loss).Results: The mean age was 40.27 ± 11.48 years, with 63.33% females and 36.67% males. The average body mass index (BMI) was 28.35 ± 1.98 kg/m². LUS scores were highest at 5 minutes post-intubation (2.42 ± 1.86) and after de-sufflation (7.95 ± 4.47). Significant differences were observed between groups, with PCV-VG showing lower LUS scores at all time points, particularly in the posterior and lateral regions (p < 0.0001).Conclusion: PCV-VG ventilation significantly reduces intraoperative and postoperative pulmonary atelectasis compared to VCV in laparoscopic surgeries. It provides better lung protection, especially in vulnerable lung zones.