In our study, the application of protective mechanical ventilation techniques in prone-position neurosurgery cases was targeted, with the goal of providing better oxygenation and ventilation in patients through personalized PEEP (Positive End-Expiratory Pressure) application compared to fixed PEEP. It was anticipated that by monitoring driving pressure and compliance parameters and determining personalized PEEP values, the risk of postoperative pulmonary complications could be reduced.
Conditions
Interventions
5 fixed PEEPs were applied to the 1st group
10 fixed PEEPs to the 2nd group
PEEP was applied gradually increasing to the 3rd group. For the 3rd group the PEEP with the lowest driving pressure and high
Sponsors
Health Sciences University Istanbul Training and Research Hospital
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Patients at or over 18 years old without lung disease who will undergo elective neurosurgery in the prone position for at least 2 hours, with ASA (American Society of Anesthesiologists) classifications of ASA 1 and ASA 2.
Exclusion criteria
Exclusion criteria: Patients under 18 years old, excluding those with ASA classifications of ASA 1 and ASA 2, as well as patients with serious lung diseases and morbidly obese patients, who are taken into emergency surgery.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| In the prone position, Pplato and Ppeak values were found to be higher in the P10 group compared to the other groups. The lowest Pmean value was found in the P5 group and the highest was in the P10 group. Pdriving value was higher in the P5 group than in the P10 and D groups. The mean PEEP value, which was determined by applying stepped PEEP in Group D, was found to be 7.41. A significant increase in Pplato and Ppeak values along with a significant decrease in compliance values were detected in all groups when transitioning from the supine position to the prone position. When the blood gas data was analyzed pH values were within normal limits in all cases and no clinically significant differences were found. While a significant decrease was observed in HR and MAP values in all groups by switching to the supine position, there were no significant changes in these parameters between the groups. In terms of the data evaluated in all three groups, no significant difference was found in terms of postoperative pulmonary complications. | — |
Countries
Europe
Contacts
Public ContactKubra Bolat Gursoy
Health Sciences University Istanbul Training and Research Hospital Department of Anesthesiology and Reanimation
Outcome results
None listed