Post-operative Pulmonary Complications
Conditions
Interventions
Intervention group:driving pressure-guided pulmonary protective ventilation combined deep neuromuscular block
Control group:normal pulmonary ventilation combined normal neuromuscular block
Sponsors
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital
Eligibility
Sex/Gender
All
Age
50 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Aged >50 years; 2. Elective laparoscopic colorectal cancer resection under general anesthesia; 3. Operation time >=2h; 4. Patients at high risk of postoperative pulmonary complications (ARISCAT score > 44).
Exclusion criteria
Exclusion criteria: 1. Unable to obtain informed consent to participate in the study; 2. Turn to open, emergency operation; 3. Comply with any of the following: (1) History of any lung and / or abdominal surgery, history of asthma or chronic obstructive pulmonary disease, acute lung injury or acute respiratory distress syndrome, which is expected to require long mechanical ventilation after surgery; (2) Persistent hemodynamic instability, intractable shock, and severe heart disease (defined as conforming to the New York Heart Association III or IV cardiac function, or acute coronary syndrome, or persistent ventricular tachycardia); (3) Patients with cerebral stroke within three months before surgery; (4) Renal insufficiency (SCr is more than 2 times the normal reference range of our hospital, and the urine volume is less than 0.5ml/(kg·h), and the glomerular filtration rate is less than 60ml/h or proteinuria); (5) Cirrhosis (Child B or C); (6) Recent immunosuppressive therapy (defined as the need for chemotherapy or radiotherapy) is less than two months from the last chemotherapy or radiotherapy; (7) Allergy to narcotic drugs, suspected or suspected malignant hyperthermia (family) history; (8) Pregnancy (excluded by laboratory examination); (9) Any or suspected neuromuscular disease; (10) The physician in charge thinks it is not suitable for this study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Postoperative pulmonary complications;Muscle relaxation monitoring; | — |
Secondary
| Measure | Time frame |
|---|---|
| Mortality;Duration of hospital stay after surgery;Modified Clinical Pulmonary Infection Score, mCPIS;Surgical Rating Scale, SRS;Soluble receptor for advanced glycation end-products, sRAGE;Neutrophil elastase, NE;Angiopoietin, ANG2;Clara cell secretory protein, CC16;Routine blood test;Inflammatory factor;Intraoperative ventilation index;Pain numerical rating scale;Postoperative nausea and vomiting;Blood gas analysis; | — |
Countries
China
Contacts
Public ContactLi Huixian
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
Outcome results
None listed