{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T18:11:07Z","timestamp":1772647867648,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Children have higher morbidity and mortality than adults during thoracic surgery with one-lung ventilation (OLV), reducing the incidence may in part be achieved by the use of appropriate mechanical ventilation mode. This study evaluated whether pressure-controlled ventilation-volume guaranteed (PCV-VG) reduces intrapulmonary shunt (Qs\/Qt) and ventilator-induced lung injury (VILI) in pediatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty children underwent thoracic surgery requiring OLV were randomly divided into PCV-VG group and volume-controlled ventilation (VCV) group. The PCV-VG group utilized the PCV-VG during surgery, whereas the other group employed the VCV. The parameter settings during two-lung and OLV were consistent between the groups. The primary outcome comprised the Qs\/Qt fraction. The secondary outcomes encompassed respiratory parameters, blood gas analysis results, the occurrence of postoperative pulmonary complications (PPCs), and more.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Following PCV-VG implementation, the median Qs\/Qt during OLV exhibited a significant improvement (18.2 to 12.7 at T2, 11.4 to 9.1 at T3, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.0001). Additionally, compared with VCV, PCV-VG improved oxygenation during OLV (higher PaO<jats:sub>2<\/jats:sub>, PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub>, and other oxygenation indices), reduced airway pressure during OLV (25cmH<jats:sub>2<\/jats:sub>O to 20cmH<jats:sub>2<\/jats:sub>O at T2, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.0001), and lowered the incidence of PPCs [38.5 to 7.3%, adjusted odds ratio (OR) 0.13, 95% confidence interval (CI): 0.03\u20130.50, <jats:italic>p<\/jats:italic>\u202f=\u202f0.001], shortened the duration of postoperative mechanical ventilation [120\u202fmin to 110\u202fmin, difference (95% CI), 20 (0 to 40), <jats:italic>p<\/jats:italic>\u202f=\u202f0.036].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Implementation of PCV-VG for children undergoing thoracic surgery demonstrated significant benefits. It can improve Qs\/Qt, increase oxygenation, reduce airway pressure, and alleviate VILI during OLV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:uri>Clinicaltrials.gov<\/jats:uri>, identifier ChiCTR2200065237.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1647682","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T05:28:24Z","timestamp":1757914104000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of pressure-controlled ventilation-volume guaranteed on children undergoing thoracic surgery: a prospective, randomized controlled 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