Research Article: Respiratory ventilation modes in selective ophthalmic arterial chemotherapy for pediatric retinoblastoma under general anesthesia
Abstract:
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.
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.
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.
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.
Introduction:
Retinoblastoma is a common primary intraocular malignant tumor, accounting for approximately 2–4% of childhood malignancies ( 1 ). If left untreated, the mortality rate can be as high as 95% ( 2 , 3 ). Compared with the orthodox treatment for retinoblastoma, local chemotherapy (intraocular injection and interventional chemotherapy) may provide a better prognosis for children with insensitive or advanced retinoblastoma ( 4 ). With the advent of fluoroscopy and the maturity of neurovascular access technology,…
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