Anesthesia
Conditions
Brief summary
General anesthesia lowers FRC thereby promoting airway closure and absorption atelectasis. Alveolar recruitment manoeuvers recruit collapsed alveoli, increase gas exchange, and improve arterial oxygenation.
Detailed description
General anesthesia lowers FRC thereby promoting airway closure and absorption atelectasis. Alveolar recruitment manoeuvers recruit collapsed alveoli, increase gas exchange, and improve arterial oxygenation. However, the effect of recruitment manoeuvre is short lasting and does not extend to the post operative period. Postoperative CPAP keeps the lung open and can improve oxygenation in the early postoperative period.
Interventions
DEVICEEngström Datex-Ohmeda ICU Ventilator
patients will be mechanically ventilated and a vital capacity manoeuvre for lung inflation will be done by increasing the PIP to 35 cmH2o for 15 seconds followed by PEEP until extubation.
DEVICEPostoperative CPAP mask
patients will be mechanically ventilated and a vital capacity manoeuvre for lung inflation will be done by increasing the PIP to 35 cmH2o for 15 seconds followed by PEEP until extubation and a CPAP mask will be applied immediately postoperative.
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
MALE
Age
6 Months to 6 Years
Healthy volunteers
No
Inclusion criteria
* Pediatric patients undergoing laparoscopic surgery for abdominal cryptorchidism.
Exclusion criteria
* Cardio-respiratory illness. * Unsatisfactory preoperative peripheral arterial oxygen saturation. * Unsatisfactory preoperative hemoglobin level. * Neurological or psychiatric disease. * Children with a BMI \>95th percentile for age.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| (A-a) DO2 | 1 hour after extubation | arterial blood gas will be withdrawn 1 hour after extubation and the alveolar minus arterial oxygen difference will be calculated for assessment of oxygenation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PaCO2 | intra-operative and 1hour postoperative | arterial blood gas samples will be withdrawn to assess PaCO2. |
| PH | intra-operative and 1hour postoperative | arterial blood gas samples will be withdrawn to assess PH. |
| Respiratory mechanics | Intraoperative | intra-operative ventilator data will be recorded to measure respiratory mechanics such as dynamic and statistic compliance |
| PaO2 | intra-operative and 1hour postoperative | arterial blood gas samples will be withdrawn to assess Pa O2. |
| Heart rate | intraoperative and 1hour postoperative | the heart rate will be recorded before and after recruitment manoeuvre, after pneumoperitonium, and after pneumoperitonium deflation and early postoperative.. |
| Peripheral arterial oxygenation SPO2% | intraoperative and 1hour postoperative | The SPO2% will be recorded before and after recruitment manouvre, after peumoperitoneum inflation and after pneumoperitoneum deflation and early postoperative |
| non invasive mean arterial pressure | intraoperative and 1hour postoperative | non invasive mean arterial pressure will be recorded before and after recruitment manouvre, after pneumoperitonium and after pneumoperitonium deflation |
Countries
Egypt
Outcome results
None listed