Spraider et al. Individualised flow-controlled ventilation versus pressure-controlled ventilation in a porcine model of thoracic surgery requiring one-lung ventilation: A laboratory study. Eur J Anaesthesiol 2022; 37:1 – 10

This publication by Dr. Spraider and colleagues describes the first study comparing individualized flow-controlled ventilation to pressure-controlled ventilation in a porcine model of simulated thoracic surgery requiring one-lung ventilation (OLV). Upon baseline measurements under two-lung ventilation, 16 healthy pigs (8 per group) received three hours of OLV with compliance-guided individualization of ventilator settings for FCV, or PCV with individualized settings according to best clinical practice. With FCV, a significantly lower minute volume (-31%; P<0.001) was sufficient to allow adequate ventilation and maintain normocapnia, whereas with PCV permissive hypercapnia had to be accepted to avoid alveolar overdistension from intrinsic PEEP (PEEPi). Furthermore, the mechanical impact of the ventilator on the lungs, reflected by calculated mechanical power during OLV, was substantially reduced in the FCV group (-65%; P<0.001), indicating a lung-protective potential of flow-controlled ventilation.