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 (PEEP_i). 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.