Which Ventilatory Strategy is Better for Lung in Upper Abdominal Surgeries?

Mansoura University

Status: Unknown

Conditions: Anesthesia Induced Atelectasis

Treatments: Procedure: High PEEP/RM; Procedure: Low PEEP; Device: Lung ultrasonogrphy assessment; Procedure: High PEEP

Study type: Interventional

Funder types: Other

Identifiers

NCT04872361

MFM-IRB.MD.21.01.412

Details and patient eligibility

About

Ventilated Patients especially those undergoing upper abdominal surgeries are prone to lung atelectasis. They are at risk of adverse effects secondary to inadequate lung ventilation.

Applied PEEP and Recruitment maneuver are thought to enhance lung aeration under general anesthesia which could be assessed by ultrasound.

Full description

The aim of our study is to assess the effect of using PEEP with and without recruitment maneuver on atelectasis and lung aeration during open upper abdominal surgeries by ultrasonography.

Application of PEEP improves intraoperative oxygenation and thus could minimize the incidence of postoperative atelectasis and respiratory complications during abdominal surgeries.

A recent study found that PEEP and RM prevented intraoperative aeration loss, which didn't persist after extubation when comparing effects of positive end-expiratory pressure/recruitment maneuvers with zero end-expiratory pressure on atelectasis during open gynecological surgery by ultrasonography

Enrollment: 117 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists' physical status grades I, II, and III.

Exclusion criteria

• Patient refusal.
• Psychiatric diseases.
• Body Mass Index > 35 Kg/m2.
• Previous intrathoracic procedures.
• History of severe obstructive pulmonary disease.
• History of severe restrictive lung disease.
• Pulmonary arterial hypertension ( systolic pulmonary arterial pressure >40 mmHg).
• Pregnancy.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

117 participants in 3 patient groups, including a placebo group

Low PEEP

Placebo Comparator group

Description:

Low positive end-expiratory pressure (PEEP) and no recruitment maneuver (RM)

Treatment:

Device: Lung ultrasonogrphy assessment

Procedure: Low PEEP

High PEEP

Active Comparator group

Description:

High positive end-expiratory pressure (PEEP)

Treatment:

Procedure: High PEEP

Device: Lung ultrasonogrphy assessment

High PEEP/RM

Active Comparator group

Description:

High positive end-expiratory pressure (PEEP) and recruitment maneuver (RM)

Treatment:

Device: Lung ultrasonogrphy assessment

Procedure: High PEEP/RM