Abdominal Cancer
Conditions
Brief summary
General anesthesia and mechanical ventilation promotes atelectasis and airway closure. The open-lung approach (OLA) strategy restores the functional residual capacity. Pulse oximetry hemoglobin saturation (SpO2) using room air can diagnose shunt induced by lung collapse during general anesthesia and the SpO2 breathing air was useful to detect the lung´s opening and closing pressure during a recruitment maneuver (RM) in morbidly obese anesthetized patients. Investigators hypothesized that the SpO2 breathing air can personalize the open-lung approach.
Detailed description
Increase in airway pressure until the SpO2 reaches 97% (lung´s opening pressure) during the incremental positive end-expiratory (PEEP) limb. Decrease in the PEEP level until the SpO2 decreases bellow 97% (lung´s closing pressure)
Interventions
OTHEROpen-lung approach
Increase and decrease in airway pressure to open the lung and keep them opened.
Sponsors
Instituto de Investigacion Sanitaria INCLIVA
Fundación para la Investigación del Hospital Clínico de Valencia
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Non-obese patients with ASA physical status I-III undergoing elective abdominal laparoscopic surgery with an expected operating time of less than 2 hours were included.
Exclusion criteria
* age of \<18 years, * preoperative SpO2 ≤97% while breathing room air, and * patients with previous known cardiac or respiratory disease.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| open-lung condition | During the experimental protocol (Intraoperative) | The role of the SpO2 to detect lung´s closing and opening pressures was evaluated by the discrete receiver operating characteristic (ROC) analysis. With PtpEE and PaO2/FIO2 as the reference methods, a binary classification of 1 to the open-lung condition defined as positive PtpEE or PaO2/FIO2 \>400 mmHg and 0 presence of lung collapse defined as negative PtpEE or PaO2/FIO2 \<400 mmHg. Also, a value of 1 was assigned when the SpO2 was ≥ 97% and a value of 0 when the value was \< 97%. |
Countries
Spain
Outcome results
None listed