abdominal surgery
Conditions
Interventions
conventional sustained inflation:The recruitment manoeuvre was performed by manual inflation with a airway pressure of 30 cmH2O for 30 s.
ultrasound-guided sustained inflation:The recruitment manoeuvre was performed under the direct real-time guidance of ultrasound. Manual inflation was applied until no collapsed areas were visible on t
conventional incremental PEEP:The recruitment manoeuvre was performed by maintaining a steady airway pressure of 15 cm H2O, with 5 cm H2O increments in PEEP until a peak airway pressure of 30 cm H2O w
ultrasound-guided incremental PEEP:The recruitment manoeuvre was performed under the direct real-time guidance of ultrasound
incremental PEEP was applied to increase the airway pressure until no collapsed areas were visible on the ultrasound. The maximum airway pressure was limited to 40 cmH2O, and the tidal volume of each
Sponsors
West China Hospital, Sichuan University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1) aged 18 years or older; 2) scheduled for abdominal surgery with an expected duration of more than 2 hours under general anaesthesia; 3) had an intermediate or high risk of having postoperative pulmonary complications according to the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score
Exclusion criteria
Exclusion criteria: 1) had contraindication of recruitment maneuvers, including pneumothorax or severe barotrauma, bullae, persistent hemodynamic instability or intractable shock, or known/suspected intracranial hypertension; 2) with a previous history of lung surgery; 3) history of severe chronic obstructive pulmonary disease (COPD, defined as non–invasive ventilation and/or oxygen therapy at home or repeated systemic corticosteroid therapy for acute exacerbations of COPD), severe cardiac disease defined as New York Heart Association class III or IV; 4) had an American Society of Anesthesiology (ASA) physical status of =IV; 5) had the technical incompatibility of the acoustic window (bandage, pneumoderm emphysema, or absence of acoustic penetration); 6) pregnancy or lactation; 7) refusal or unable to give written informed consent; 8) enrollment in another interventional study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| postoperative atelectasis;days at home at 30 days after surgery(DAH30); | — |
Secondary
| Measure | Time frame |
|---|---|
| atelectasis at the end of surgery;postoperative lung ultrasound score;lung ultrasound score at the end of surgery;postoperative hypoxemia;postoperative oxygenation index;hypotension during recruitment maneuvers;postoperative pulmonary complications;in-hospital mortality;length of postoperative stay;hospitalization cost; | — |
Countries
China
Contacts
Public ContactHai Yu
West China Hospital, Sichuan University
Outcome results
None listed