Intrinsic PEEP During Mechanical Ventilation of Patients With Obesity

Seoul Medical Center

Status: Completed

Conditions: Laparoscopic Cholecystectomy; General Anesthesia

Treatments: Device: RR 16 + 0; Device: RR 10 + 0; Device: RR 10 + 5; Device: RR 6 + 0; Device: RR 6 + 5; Device: RR 16 + 5

Study type: Interventional

Funder types: Other

Identifiers

NCT01267916

SMC-2010-12-13

Details and patient eligibility

About

It is demonstrated that expiratory flow limitation and as a consequence, intrinsic positive end-expiratory pressure (PEEP) is present in grossly obese subjects especially in the supine position. The investigators tried to investigate the effect of low respiratory rate and high tidal volume on the intrinsic PEEP and gas exchange for obese subjects undergoing general anesthesia.

Full description

Impaired gas exchange is a common anesthetic problem in obese subjects. It is demonstrated that expiratory flow limitation and as a consequence, intrinsic positive end-expiratory pressure (PEEPi) is present in grossly obese subjects especially in the supine position. It is known that there is a significant negative correlation between PEEPi present and PaO2. Therefore, the investigators postulated that if the reduce the PEEPi by reducing the respiratory rate in obese subjects, the impaired gas exchange might improve.

The investigators tried to research the effect of low respiratory rate and high tidal volume on the intrinsic PEEP and gas exchange for obese subjects undergoing general anesthesia.

Enrollment: 20 patients

Sex: All

Ages: 20 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ASA class I or II obesity, Body-mass index > 27.5 undergoing laparoscopic cholecystectomy

Exclusion criteria

• patients with severe cardiopulmonary disease peak inspiratory pressure > 40 in the study setting

Trial design

20 participants in 6 patient groups

RR 6 + 0

Experimental group

Description:

Respiratory rate 6 Tidal volume 16.7 ml/kg external PEEP = 0

Treatment:

Device: RR 6 + 0

RR 10 + 0

Experimental group

Description:

Respiratory rate 10 Tidal volume 10 ml/kg external PEEP = 0

Treatment:

Device: RR 10 + 0

RR 16 + 0

Experimental group

Description:

Respiratory rate 16 Tidal volume 6.25 ml/kg external PEEP = 0

Treatment:

Device: RR 16 + 0

RR 6 + 5

Experimental group

Description:

Respiratory rate 6 Tidal volume 16.7 ml/kg external PEEP = 5

Treatment:

Device: RR 6 + 5

RR 10 + 5

Experimental group

Description:

Respiratory rate 10 Tidal volume 10 ml/kg external PEEP = 5

Treatment:

Device: RR 10 + 5

RR 16 + 5

Experimental group

Description:

Respiratory rate 16 Tidal volume 6.25 ml/kg external PEEP = 5

Treatment:

Device: RR 16 + 5