الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This study investigated the effects of mechanical ventilation modes on patients with diastolic dysfunction during anesthesia for radical cystectomy. The review discussed how mechanical ventilation affects oxygen delivery by altering lung volumes, autonomic tone, and pulmonary vascular resistance1. It emphasized the interplay between the heart and lungs due to their common location in the thoracic cavity, affecting blood flow and pressures during the respiratory cycle. It covered the concepts of preload related to right ventricular (RV) end-diastolic volume and afterload as the force resisting ventricular ejection3. The review explained how these are influenced by intrathoracic pressure. (ITP) changes and lung volumes during mechanical ventilation understanding diastolic dysfunction (DD) in the perioperative setting, its pathophysiology, and the grading of its severity. It also pointed to the implications of DD for perioperative care, including the use of vasopressors and .inotropes, and the potential benefits of non-invasive monitoring techniques like electrical cardiometry. This study has compared different mechanical ventilation modes, such as volume-controlled (VCV) and pressure-regulated volume-controlled (PRVC), and their impact on hemodynamic. It also described how recent ventilators can adjust to maintain desired tidal volumes and pressures adult patients with diastolic dysfunction, including those with comorbidities like hypertension or diabetes, 86 scheduled for radical cystectomy and urinary diversion, and excluded those with a BMI <25 and >35. Patients were randomly assigned to two groups based on informed consent. The study aimed to compare the effects of different ventilation modes during a radical cystectomy. The VCV-PRVC group was ventilated by VCV mode until the which continued till the end of radical cystectomy, while the PRVC-VCV group was initiated and .switched to VCV mode. The primary outcomes included the noradrenaline dose used during anesthesia and the evaluation of cardiac output indices and stroke volume changes to maintain hemodynamic stability, while the Secondary Outcomes involved assessing inotropic administration, difficulty in weaning from mechanical ventilation due to diastolic.dysfunction, and the incidence of postoperative complications like myocardial ischemia and pulmonary edema. Our study has concluded that there were no major differences in hemodynamic parameters CO, CI, SV, SVI and SVV. Also, as regard fluid status, contractility and cardiac function, vascular resistance, tissue oxygenation, and clinical outcomes VCV and PRVCV modes of ventilation. Both modes are safe in patients with diastolic dysfunction undergoing open radical cystectomy