Elderly Hip Fracture
Conditions
Interventions
Control group:Mechanical ventilation is performed as usual.
Combined Intervention Group:Perioperative Inspiratory Muscle TrainingIntraoperative Individualized PEEP.
Sponsors
The Affiliated Hospital of Xuzhou Medical University
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Aged = 65 years, regardless of gender; 2.Radiologically (X-ray or CT) confirmed femoral neck fracture, intertrochanteric femoral fracture, or subtrochanteric femoral fracture; 3.Scheduled for hip fracture surgery under general anesthesia (including internal fixation and artificial joint replacement); 4.American Society of Anesthesiologists (ASA) physical status classification I–III; patients with ASA ? who are assessed as operable may be included after ethical approval; 5.No significant cognitive impairment as evaluated by the Mini-Mental State Examination (MMSE) preoperatively (score = 20 for patients with primary school education or below, = 24 for others), and no history of dementia or severe mental illness; 6.Informed consent obtained from patients or their family members, with signed written informed consent forms;
Exclusion criteria
Exclusion criteria: 1.Preoperative history of neurological diseases (e.g., stroke, epilepsy, craniocerebral trauma, brain tumor) or mental illness; 2.Preoperative moderate to severe cognitive impairment, dementia, depression, or delirium; 3.Preoperative severe cardiopulmonary insufficiency unable to tolerate PEEP (Positive End-Expiratory Pressure) or breathing training; 4.ASA physical status classification = ?, unable to tolerate anesthesia and surgery; 5.Preoperative infection or systemic inflammatory state (body temperature > 38?, CRP > 20 mg/L); 6.Use of sedatives, antipsychotics, or anticholinergic drugs within 7 days before surgery.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| incidence of postoperative neurocognitive disorder within 30 days after surgery; | — |
Secondary
| Measure | Time frame |
|---|---|
| changes in inflammatory factor levels;changes in oxygenation function;ncidence of postoperative complications;differences in intraoperative cerebral oxygen saturation indices; | — |
Countries
China
Contacts
Public ContactJiao Hao
The Affiliated Hospital of Xuzhou Medical University
Outcome results
None listed