Evaluation of Protective Pulmonary Ventilation by Pulmonary Ultrasound

General Hospital of Ningxia Medical University

Status: Unknown

Conditions: Assessment

Treatments: Behavioral: recruitment maneuvers

Study type: Observational

Funder types: Other

Identifiers

NCT04991727

KYLL-2021-277

Details and patient eligibility

About

Peri - operative ultrasonography was used to evaluate the effects of protective lung ventilation on the postoperative lungs of obese patients.The purpose of this study was to apply ultrasound lung ventilation area score to the monitoring of pulmonary complications in patients with postoperative obesity.To verify the reliability and practicability of perioperative lung ultrasound quantitative scoring.

Full description

Ultrasound lung ventilation area score was applied to monitor the pulmonary complications of patients after obesity operation to verify the perioperative period.

The reliability and practicability of quantitative lung ultrasound score to clarify the effect of protective lung ventilation under perioperative pulmonary ultrasound monitoring on obesity patients.To guide the management of mechanical ventilation under general anesthesia and the prevention and treatment of postoperative pulmonary complications

Enrollment: 100 estimated patients

Sex: All

Ages: 18 to 100 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• enrollment of patients aged 18 years or above；
• Eligible adult patients had an American Society of Anesthesiologists (ASA) physical status classification of I to IV
• undergoing elective or expedited nonurgent, noncardiac surgery with general anesthesia

Exclusion criteria

• patient refusal;
• morbid obesity (BMI >40 kg/ m²);
• American Society of Anesthesiologists (ASA) physical status categories IV-V;
• previous intrathoracic procedure;
• severechronic obstructive pulmonary disease (forced expiratory volume in 1 s <30% of the predicted value;
• a contraindication to radial artery cannulation.

Trial design

100 participants in 2 patient groups

PEEP

Description:

The patient was admitted to the operating room, and routine ECG monitoring was performed. The patient was placed in supine position, and ultrasound lung examination was performed. The images of the patient were saved and the score of lung ventilation area was recorded. The induction of general anesthesia was started, and endotracheal intubation was performed after 3min of preoxygenation (100% O2) to establish a safe and effective artificial airway.Mechanical ventilation was performed after endotracheal intubation, and a second time was performed immediately after endotracheal intubation was completed.Pulmonary ultrasound was performed. The PEEPgroup was given the first RM (pulmonary retraction) with pressure maintained at 40cmH2O for 30s, followed by a 7cmH2O PEEP to maintain mechanical ventilation, and the RMS was repeated every 30 minutes until the end of surgery

Treatment:

Behavioral: recruitment maneuvers

ZEEP

Description:

The patient was admitted to the operating room, and routine ECG monitoring was performed. The patient was placed in supine position, and ultrasound lung examination was performed. The images of the patient were saved and the score of lung ventilation area was recorded. The induction of general anesthesia was started, and endotracheal intubation was performed after 3min of preoxygenation (100% O2) to establish a safe and effective artificial airway. Mechanical ventilation was performed after endotracheal intubation, and a second time was performed immediately after endotracheal intubation was completed On pulmonary ultrasound, patients in the ZEEP group maintained normal mechanical ventilation throughout the operation without PEEP or RMS

Treatment:

Behavioral: recruitment maneuvers