Health Condition 1: null- Adult patients with intraabdominal infection undergoing laparotomy
Conditions
Interventions
Intervention1: Lung protective ventilation: protective lung ventilation with tidal volume 6 to 8ml/kg and PEEP 6 to 8cm H2O, along with recruitment maneuvers (30 cm H2O for 30 seconds) every half hour
Sponsors
Dr Dalim Kumar Baidya
Eligibility
Inclusion criteria
Inclusion criteria: Age between 18 and 70 years Emergency laparotomy expected duration >2 hours and Peritonitis (suspected or identified abdominal source of infection) of less than 5 days duration Preoperative risk index for pulmonary complications >2
Exclusion criteria
Exclusion criteria: 1. Mechanical ventilation within 2 weeks preceding surgery 2. BMI >= 35, 3. History of respiratory failure or sepsis within the 2 weeks preceding surgery 4. Requirement for intrathoracic surgery, history of lung surgery 5. History of smoking or COPD, with (non-invasive) ventilation and/or oxygen therapy at home and/or repeated systemic corticosteroid therapy for acute exacerbations of COPD 6. Progressive neuromuscular illness 7. ALI or acute respiratory distress syndrome expected to require prolonged post-operative mechanical ventilation, 8. Persistent hemodynamic instability or intractable shock
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pulmonary complications occurring up to day 7 after surgery 1. Acute respiratory failure Mild respiratory failure responding to supplemental oxygen Severe respiratory failure requiring invasive or noninvasive mechanichal ventilation 2. Pneumonia 3. ARDS 4. PneumothoraxTimepoint: Pulmonary complications occurring up to day 7 after surgery 1. Acute respiratory failure Mild respiratory failure responding to supplemental oxygen Severe respiratory failure requiring invasive or noninvasive mechanichal ventilation 2. Pneumonia 3. ARDS 4. Pneumothorax | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Pulmonary complications graded on a scale 0 to 410 2. Ventilation related adverse events during surgery 3. Severe sepsis, septic shock, organ dysfunction 4. Number of days of ICU admission and duration of hospital stay 5. Surgical complications 6. Pre and postoperative serum IL 6, IL 8, and TNFα â?? first sample will be obtained at the beginning of surgery and second sample will be obtained at 24 hoursTimepoint: Till the discharge | — |
Countries
India
Contacts
Public ContactDr Dalim Kumar Baidya
All India Institute of Medical Sciences, New Delhi
Outcome results
None listed