Abstract
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 (EtCO(2)), 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 EtCO(2) 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 HCO(3) (-) 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.