Effect of Different Peep Values on Gastric Residual Volume

Ankara City Hospital

Status: Completed

Conditions: Respiratory Aspiration of Gastric Content

Treatments: Procedure: PEEP 8; Procedure: PEEP 0; Procedure: PEEP 4

Study type: Interventional

Funder types: Other

Identifiers

NCT06371378

gastric residual volume

Details and patient eligibility

About

The aim of this study was to predict the effect of gastric antrum diameter before extubation on intra-abdominal pressure changes and consequently on the risk of pulmonary aspiration in patients undergoing elective spinal surgery under general anaesthesia in the prone position in the Neurosurgery Operating Theatre of the Ministry of Health Ankara City Hospital and to take precautions accordingly. Gastric antrum diameter and intraabdominal pressure measurements may contribute to the improvement of anaesthetic practice by reducing the risk of pulmonary aspiration and additional complications.

Full description

Prone positioning in spinal surgery is a very important issue for anaesthetists. Although there are many conditions that are taken into consideration in patient follow-up, it is a position frequently used in the treatment of pulmonary diseases other than surgery. PEEP application in the prone position is especially used in the treatment of conditions such as acute respiratory distress syndrome (ARDS). This treatment method basically aims to improve oxygenation and ventilation in the lungs. While providing improvement in the lungs, it may indirectly lead to some changes in the gastrointestinal system. Depending on PEEP levels, intra-abdominal pressure may increase and subsequently cause reflux of gastric contents or gastroparesis. The prone position itself also increases the risk of reflux. Gastric POCUS (Point of Care Ultrasound) is a noninvasive method that gives us information about the stomach contents and can be easily performed at the bedside. Both patient position and respiratory parameters, such as PEEP, may have an effect on gastric POCUS. Visualization of gastric content or detection of gastric retention allows us to predict possible pulmonary aspiration complications before extubation, and gastric POCUS may be a valuable marker before extubation in patients who remain in prone positions for a long time. The aim of this study was to determine the effect of PEEP application on the antrum diameter evaluated by gastric POCUS and the risk of aspiration before extubation in patients undergoing spinal surgery in the prone position.

Enrollment: 111 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

• 18-65 years of age
• ASA I-II risk group

Exclusion Criteria:

• Asthma
• COPD
• Gastroesophageal reflux
• Gastric herniation
• Gastric surgery,
• Intracranial tumor
• Epilepsy
• Neuromuscular disease

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Single Blind

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111 participants in 3 patient groups

GROUP I: PEEP 0

Active Comparator group

Description:

Patients will receive 0 cmH20 PEEP

Treatment:

Procedure: PEEP 0

GROUP II: PEEP 4

Active Comparator group

Description:

Patients will receive 4 cmH20 PEEP

Treatment:

Procedure: PEEP 4

GROUP III: PEEP 8

Active Comparator group

Description:

Patients will receive 8 cmH20 PEEP

Treatment:

Procedure: PEEP 8