E66.2
Conditions
Interventions
Group 1: PEEP Recruitment Group
• Presure Controlled Ventilation Mode (I:E 1:2
Druckkontrollierter Beatmungsmodus (I:E 1:2, respiratory rate 6/min).
• Initial PEEP 10 cmH2O and inpirational pressure 30 cmH2O
• PEEP and inspirational pressure increase of 5cm H2O each after every
Sponsors
Universitätsklinikum Augsburg
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: - Patients undergoing surgery under general anaesthesia (intubation anaesthesia). - Moderate to high risk of postoperative pulmonary complications (ARISCAT score = 26). - BMI = 40 kg/m2 - Expected duration of intubation = 2 hours
Exclusion criteria
Exclusion criteria: - Previous lung surgery (any) - Persistent haemodynamic instability - Known severe COPD (non-invasive ventilation and/or long-term oxygen therapy, repeated systemic corticosteroids due to repeated exacerbations) - Immunosuppressive medication or radiotherapy within the last 2 months before inclusion - Heart failure = NYHA III, acute coronary syndrome - Pregnancy (exclusion by history or laboratory test) - ARDS - Severe pulmonary arterial hypertension, defined as systolic pulmonary arterial pressure > 40 mmHg - Elevated intracranial pressure - Any neuromuscular disease - Implanted cardiac assist devices, pacemakers or ICDs - Intraoperative prone or lateral positioning - Procedures with single lung ventilation - Cardiac surgery - Neurosurgical procedures - Inclusion in other interventional study according to AMG/MDPG or lack of consent to participate in the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Delta EELV (measured by EIT) 1 minute after the recruitment manoeuvre 30 minutes after induction of anaesthesia and intubation (T2) compared to the time point 1 minute after induction of anaesthesia and intubation (T1). | — |
Secondary
| Measure | Time frame |
|---|---|
| • Delta EELV 1 min after recruitment manoeuvre 10 min after intubation (T1) • Delta EELV 1 minute after the recruitment manoeuvre 60 min after intubation (T3) • Delta EELV 1 minute after recruitment manoeuvre 120 min intubation (T4) • Percentage distribution of tidal volume in ventral and dorsal lung segments at time points T1, T2, T3 and T4 • Atelectasis formation at time points T1, T2 and T3 and 30 min after arrival in the recovery room/intensive care unit (T4), measured by sonography (Lung Ultrasonography Score) • PaO2/FiO2 at time points T1, T2, T3 • Complications associated with the recruitment manoeuvre - Hypotension (defined as systolic arterial blood pressure 2 min) - Bradycardia (defined as heart rate < 40/min). - Vasopressor consumption during the recruitment manoeuvre - Postoperative respiratory insufficiency (oxygen demand in recovery room/intensive care unit, non-invasive ventilation, unplanned reintubation. | — |
Countries
Germany
Contacts
Public ContactFelix Girrbach
Universitätsklinikum Augsburg
Outcome results
None listed