Impact of LPV During OFA on Postoperative Oxygen Saturation.

AZ Sint-Jan AV

Status: Unknown

Conditions: Oxygen Saturation

Treatments: Procedure: LPV; Procedure: routine LV

Study type: Observational

Funder types: Other

Identifiers

NCT04192305

OS impact LPV on SAT d OFA

Details and patient eligibility

About

Observational study comparing patients with lung protective ventilation (LPV) following the consensus guidelines by Young C with patients getting routine lung ventilation, both during opioid free anesthesia (OFA).

Full description

The paper by C Young et al describes the essential steps in protecting the lungs and preventing post operative pulmonary complications (PPC) like alveolar collapse.

Alveolar collapse can be measured by oxygen saturation drop when no oxygen therapy is given, when full neuromuscular block (NMB) reversal and no opioid is given intra and postoperative.

LPV means:

tidal volume of 6 ml/kg, inspiratory-expiratory (I/E) ratio of 1/1, positive end expiratory pressure (PEEP) minimum 5 cmH20 and higher during laparoscopy in obese patients, Inspiratory oxygen concentration (FIO2) max 80% during induction and max 40 % during maintenance and extubation. Extubation in an awake, full NMB reversed patient getting no opioids while giving continuous positive airway pressure (CPAP) during withdrawal of the tube. Lung recruitment maneuver (LRM) when lung compliance decreases below 40 milliliter per centimeter water. (ml/cmH2O)

Enrollment: 100 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• bariatric surgery
• morbid obesity ( BMI > 35)

Exclusion criteria

• patients with pre existing severe cardio-pulmonary diseases having oxygen saturation without oxygen below 94%.

Trial design

100 participants in 2 patient groups

lung protective ventilation (LPV)

Description:

lung protective ventilation low tidal volume, minimum PEEP and higher PEEP and lung recruitment based on total lung compliance, low inspiratory oxygen concentration and CPAP during extubation without prior suctioning inside the endotracheal tube.

Treatment:

Procedure: LPV

routine lung ventilation (LV)

Description:

ventilation and adapting PEEP, LRM and oxygen only when saturation drops.

Treatment:

Procedure: routine LV