Atelectasis
Conditions
Brief summary
This study test whether a lung recruitment maneuver improves the right ventricle performance after cardiopulmonary bypass. Half of the patients received an standard protective ventilation and the other half the same ventilatory pattern after a lung recruitment maneuver.
Detailed description
Atelectasis is developed in 90% of anesthetized patients after surgery. Protective ventilation with low tidal volumes and positive-end expiratory pressure (PEEP) promotes atelectasis with the potential right ventricle dysfunction induced by the increment in afterload (activation of the pulmonary hypoxic vasocontriction reflex). Lung recruitment can improve the right ventricle performance caused by atelectasis because the pulmonary hypoxic vasocontriction reflex desapear in a normal aerated lungs.
Interventions
PROCEDURELung recruitment maneuver
The lung recruitment maneuver consists in a brief and controlled increment in airways pressure (20 cmH2O of PEEP + 20 cmH2O of driving pressure) for 10 breaths.
Sponsors
Hospital Privado de Cordoba, Argentina
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
40 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* cardiovascular surgery with cardiopulmonary bypass. * Patients with a New York Heart Association (NYHA) class I-II, * Pre-operative left ventricular ejection fraction ≥ 50 %. * Euroscore ≤ 6.
Exclusion criteria
* TEE contraindications. * Hemodynamically unstable * Needi for inotropic support
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Right ventricle assessment by transesophageal echocardiography | intraoperative |
Secondary
| Measure | Time frame |
|---|---|
| Atelectasis assessment by transesophageal echocardiography | intraoperative |
| PaO2 and respiratory compliance | intraoperative |
Outcome results
None listed