Postoperative Pulmonary Complications
Conditions
Interventions
1:high tidal volume[10ml/kg ideal body weight], zero-positive end-expiratory pressure[ZEEP], without using recruitment maneuvers (RMs), regular moderate neuromuscular block(TOF=1-2), regular intra-abd
2:high tidal volume(10ml/kg ideal body weight), zero-positive end-expiratory pressure[ZEEP], without using recruitment maneuvers (RMs), deep neuromuscular block(TOF=0, PTC=1-2), lower intra-abdominal
3:low tidal volume(6-8ml/kg ideal body weight), high level of positive end-expiratoty pressure, with using recrutment maneuvers, regular moderate neuromuscular block(TOF=1-2), regular intra-abdominal
4:low tidal volume(6-8ml/kg ideal body weight), high level of positive end-expiratoty pressure, with using recrutment maneuvers, deep neuromuscular block(TOF=0, PTC=1-2), lower intra-abdominal pressur
Sponsors
Cancer Hospital Chinese Academy of Medical Sciences
Eligibility
Sex/Gender
All
Age
40 Years to 60 Years
Inclusion criteria
Inclusion criteria: Gastrointestinal tumors patients scheduled for elective laparoscopic abdominal surgery under general anesthesia expected to last more than 2 hours andage more than 40 yr from October 2015 to March 2017 are selected in Cancer Hospital Chinese Academy of Medical Sciences.
Exclusion criteria
Exclusion criteria: Above ASA Class III, body mass index more than 40 kg/m2, age younger than 40 yrs or older than 60 yrs, cant obtain informed consent, transfer to open during sugery, need for surgery in emergency, previous lung surgery (any) and/or abdonimal surgery, persistent hemodynamic instability, intractable shock, considered unsuitable for the study by the patients managing physician, history of chronic obstructive pulmonary disease, repeated systemic corticosteroid therapy for acute exacerbations of chronic obstructive pulmonary disease, asthma or sleep disorders, recent immunosuppressive medication defied as need of chemotherapy or radiation therapy, less than 2 months after chemotherapy or radiation therapy, severe cardiac disease defied as New York Heart Association class III or IV, or acute coronary syndrome, or persistent ventricular tachyarrhythmias, pregnancy (excluded by laboratory analysis), acute lung injury or acute respiratory distress syndrome, expecting to require prolonged postoperative mechanical ventilation, any neuromuscular disease, allergy to anesthetics, history of or suspicious to Malignant Hyperthermia, renal insufficiency defined as SCr more than two-fold normal reference value, urine volume lower than 0.5ml/kg/h, glomerular filtration rate under 60ml/h or proteinuria.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Modified Clinical Pulmonary Infection Score; | — |
Secondary
| Measure | Time frame |
|---|---|
| the change in arterial oxygenation in air;the change in peripheral oxygen saturation in air;plasma Neutrophil Elastase, NE;the rate of complications during recruitment, anesthesia,; | — |
Countries
China
Contacts
Public ContactZheng Hui
Outcome results
None listed