Health Condition 1: C40- Malignant neoplasm of bone and articular cartilage of limbs
Conditions
Interventions
Intervention1: Optimum positive end expiratory pressure(PEEP): optimum positive end expiratory pressure(PEEP) will be applied based on best dynamic lung compliance. PEEP will be decreased by 2cmH2O fr
Sponsors
Deaprtment of anaesthesiology pain medicine and critical care
Eligibility
Inclusion criteria
Inclusion criteria: 1. Elective major orthopaedic surgery in supine position
Exclusion criteria
Exclusion criteria: 1. Parental refusal to participate in the study. 2. Children with known severe lung disease. 3. Children with a history of severe lung infection having post infection sequelae in preoperative chest x-ray. 4. Children with known deformity of chest wall or thoracic spine. 5. Children undergoing spine surgery in prone or lateral position. 6. Children with pre-existing significant cardiac, renal or hepatic diseases. 7. Children with history of previous thoracic surgery. 8. Children with BMI > 30 kg/m2
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To find the incidence of significant atelectasis defined as consolidation score 2 in any region in post operative lung ultrasound assessment.Timepoint: lung ultrasound images will be obtained at 4 predefined time points: T-1 Before induction of general anaesthesia T-2 Five minutes after intubation before lung recruitment T-3 Before extubation T-4 One hour after extubation in PACU (Post Anaesthesia Care Unit) | — |
Secondary
| Measure | Time frame |
|---|---|
| Correlation of lung ultrasound score with PaO2 / FiO2 ratio Body Mass Index Alveolar-arterial oxygen gradient Duration of surgery Incidence of intraoperative hypotension and bradycardia in both groups. Change in driving pressure during intraoperative period between both groups. Change in lung compliance during intraoperative period between both groups. Duration of oxygen supplementation required to maintain SpO2 94% in each group in the first postoperative day . Timepoint: Hemodynamic monitoring,saturation: 15 minute intervals after induction Respiratory mechanics:5 min after intubation,after lung recruitment,30 min interval intraoperatively,before extubation ABG- after induction, before extubation, 1 hour after extubation in PACU | — |
Countries
India
Contacts
Public ContactDr Rakesh Kumar
All India Institute of Medical Sciences
Outcome results
None listed