Atelectasis, Compression, Pulmonary Atelectasis, Postoperative
Conditions
Brief summary
This study evaluates the incidence of postoperative atelectasis after general anesthesia with prone position using lung ultrasound in children age \< 3 years.
Detailed description
Atelectasis is common in pediatric patients after general anesthesia. Particularly, infants are more likely to develop atelectasis or ventilation-perfusion imbalance after general anesthesia because of the immature ribs and respiratory muscles, the high compliance of the rib cage and a significant reduction in functional residual capacity (FRC) during general anesthesia. Previous studies have reported that alveolar recruitment and positive end-expiratory pressure (PEEP) can be used to reduce atelectasis in children. Also, previous studies have shown that the lung ultrasound can be used to evaluate the degree of atelectasis during general anesthesia in children. However, none of the previous studies investigated the incidence of atelectasis, the effect of alveolar recruitment, and the PEEP in pediatric patients under general anesthesia with prone position. The purpose of this study was to evaluate previously described parameters using lung ultrasound.
Interventions
PROCEDURERepetitive recruitment with PEEP
Apply sustained airway pressure of 30-40 cmH2O for 10-20 seconds before suegery and once an hour during surgery. PEEP is set to 7 cmH2O.
PROCEDUREOne recruitment with PEEP
Apply sustained airway pressure of 30-40 cmH2O for 10-20 seconds before surgery. PEEP is set to 7 cmH2O.
Sponsors
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
No minimum to 3 Years
Healthy volunteers
No
Inclusion criteria
* Children undergoing general anesthesia with prone position * Endotracheal intubation and mechanical ventilation during general anesthesia * Operation time is more than 2 hours
Exclusion criteria
* Previous lung surgery * Any abnormal findings such as atelectasis, pneumothorax, pleural effusion, or pneumonia on preoperative chest X-ray * Researchers judge (to be inappropriate)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of pre-extubation atelectasis | postoperative 10 minutes | Incidence of pre-extubation atelectasis accessed by lung ultrasound |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of intraoperative atelectasis after intubation | intraoperative | Incidence of intraoperative atelectasis after induction accessed by lung ultrasound |
| Incidence of intraoperative atelectasis after position change to prone | intraoperative | Incidence of intraoperative atelectasis after position change to prone accessed by lung ultrasound |
| Incidence of intraoperative and postoperative (within 12hr) desaturation | intraoperative and postoperative (within 12hr) | Oxygen saturation by pulse oximetry (SpO2) ≤ 95% or 10% below the baseline value |
| Incidence of intraoperative hypotension | intraoperative | Systolic blood pressure (SBP) ≤ 20% below the baseline value |
Countries
South Korea
Outcome results
None listed