Health Condition 1: K630- Abscess of intestine Health Condition 2: K260- Acute duodenal ulcer with hemorrhage Health Condition 3: K252- Acute gastric ulcer with both hemorrhage and perforation Health Condition 4: K250- Acute gastric ulcer with hemorrhage Health Condition 5: K251- Acute gastric ulcer with perforation Health Condition 6: K311- Adult hypertrophic pyloric stenosis Health Condition 7: C223- Angiosarcoma of liver Health Condition 8: K835- Biliary cyst Health Condition 9: K266- Chronic
Conditions
Interventions
Intervention1: Intraoperative transpulmonary pressure guided PEEP titration: A nasogastric tube with an esophageal balloon (Avea
Carefusion) will be positioned to allow the pressure measurement at mid-esophageal level. After the disappearance of heart rate synchronous artefacts, the probe will be retracted another 1-2cm until o
Sponsors
All India Institute of Medical Sciences
Eligibility
Inclusion criteria
Inclusion criteria: 1. Patients of ASA Physical Status I – III scheduled for elective upper abdominal surgery with expected duration of surgery more than 1 hour under general anaesthesia. 2. BMI between 18 and 35 kg/m2. 3. Age more than 18 years.
Exclusion criteria
Exclusion criteria: 1. Patient refusal 2. Emergency surgeries 3. Previous history of any thoracic surgeries 4. Pregnancy 5. Any nasopharyngeal or oropharyngeal pathologies 6. Contraindications to nasogastric tube placement. 7. Any laparoscopic surgeries being converted to open surgeries. 8. Chronic Obstructive Pulmonary Disease, Bronchial Asthma or other chronic lung diseases 9. Deformity of chest wall or thoracic spine 10. preoperative diagnosis of pneumonia 11. BMI 35 kg/m2 12. Significant cardiac, renal or hepatic diseases 13. Intraoperative massive blood loss (blood loss >40ml/kg) or massive transfusion ( >8 PRBC transfusion during surgery) 14. Patients on high dose vasopressor (noradrenaline > 10mcg/min or equivalent)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Post operative pulmonary complications till day 5 as per Melbourne group score greater than or equal to 2Timepoint: Till day 5 | — |
Secondary
| Measure | Time frame |
|---|---|
| 2. Intra operative and post operative oxygenation status measured by PaO2/FiO2 ratio after peep titration. 3. Post operative atelectasis measured by Lung Ultrasound Score. 4. Any treatment related adverse effects. Timepoint: Anaesthesia care time during surgery | — |
Countries
India
Contacts
Public ContactAravind M
All India Institute of Medical Sciences
Outcome results
None listed