Laparoscopic surgery for pulmonary complications
Conditions
Interventions
Individualized PEEP group (Group D):After the CO2 pneumoperitoneum is stabilized, perform the pressure recruitment maneuver. In PCV mode, maintain the inspiratory pressure constant and incrementally i
Conventional lung-protective ventilation group (Group C):After the CO2 pneumoperitoneum is stabilized, perform the pressure recruitment maneuver. In PCV mode, maintain the inspiratory pressure constan
Sponsors
Central Hospital Affiliated to Shandong First Medical university
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Patients aged >=65 years, regardless of gender, scheduled for elective laparoscopic surgery. 2.Orotracheal intubation with mechanical ventilation. 3.ASA physical status classification I to III. 4.Anticipated surgical duration >2 hours. 5.Voluntarily signed informed consent form by the patient..
Exclusion criteria
Exclusion criteria: 1.Pre-existing significant respiratory diseases, including chronic obstructive pulmonary disease (COPD), severe or uncontrolled bronchial asthma, active pulmonary infections, etc. 2.Cardiac or renal dysfunction, such as preoperative renal replacement therapy, congestive heart failure (NYHA class III or IV), or severe dysfunction of other major organs. 3.?Preoperative hypoxemia: SpO2 30 kg/m². Withdrawal Criteria: ?1.Inability to maintain adequate oxygenation or severe hypotension induced by ventilation strategies. 2.?Intraoperative severe complications (e.g., massive hemorrhage, refractory arrhythmia). 3.Conversion to open laparotomy during surgery. ? 4.Inadequate visualization of lung ultrasound images (e.g., due to subcutaneous emphysema or poor acoustic window).
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| Airway platform pressure;Peak Airway Pressure;?Dynamic Lung Compliance;Postoperative pulmonary complications within three days;Heart Rate;Mean Arterial Pressure;Arterial Partial Pressure of Oxygen;Arterial Partial Pressure of Carbon Dioxide;Oxygenation Index;Alveolar-Arterial Oxygen Gradient;Intrapulmonary Shunt Fraction;Postoperative pulmonary complications; | — |
Primary
| Measure | Time frame |
|---|---|
| Lung ultrasound score (LUS) to assess the degree of atelectasis.; | — |
Countries
China
Contacts
Public ContactZelong Tan
Central Hospital Affiliated to Shandong First Medical university
Outcome results
None listed