Pulmonary Atelectasis
Conditions
Brief summary
The study aims to compare the degree of atelectasis between ultrasound-guided alveolar recruitment group and conventional alveolar recruitment group in patients receiving laparoscopic gynecologic surgery
Interventions
PROCEDURElung ultrasound-guided alveolar recruitment
Alveolar recruitment maneuver will be performed under lung ultrasound-guidance. Positive pressure will be not exceed 40cmH2O and duration of positive pressure inflation will not exceed 10 seconds.
PROCEDUREconventional alveolar recruitment
Alveolar recruitment will be provided with positive pressure of 30cmH2O for 10 seconds
Sponsors
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients scheduled to undergo elective laparoscopic gynecological surgery (laparoscopic ovarian cystectomy or laparoscopic salpingo-oophorectomy or laparoscopic hysterectomy or laparoscopic myomectomy) under general anesthesia, with ASA physical status classification I or II
Exclusion criteria
* Previous history of lung surgery * Patients having pneumonia, pneumothorax, or pleural effusion in preoperative chest X-ray * Patients with COPD, emphysema * Patients with previous history of pneumothorax, or bullae * Morbid cardiac disease * Adolescent aged \< 18 years * Anticipated duration of surgery \< 1 hour
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| modified lung ultrasound score at the end of surgery | At the end of surgery | Both lung ultrasound scores can be calculated by adding up the 12 individual pulmonary quadrant scores yielding a score between 0 (no aeration loss) and 36 (complete aeration loss). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| incidence of atelectasis diagnosed by ultrasonography | intraoperative | the presence of atelectasis by ultrasonography |
| arterial blood gas analyses | intraoperative | PaO2, PaCO2, SaO2, O2 index (PaO2/FiO2) |
| incidence of postoperative complications | during the postoperative period until discharge from hospital, an average of 3 days | fever, pneumonia, atelectasis diagnosed by chest X-ray |
| modified lung ultrasound score at post-anesthesia care unit (PACU) | intraoperative | Both lung ultrasound scores can be calculated by adding up the 12 individual pulmonary quadrant scores yielding a score between 0 (no aeration loss) and 36 (complete aeration loss). |
| intraoperative SpO2 | intraoperative | SpO2 in % |
| intraoperative peak airway pressure | intraoperative | peak airway pressure in cmH2O |
| Incidence of postoperative shoulder pain at POD #1 | assessed at postoperative day 1 | patients will be asked whether they have shoulder pain or not, using NRS (0 to 10) scale |
| intraoperative mean arterial pressure | intraoperative | mean arterial pressure in mmHg |
Countries
South Korea
Outcome results
None listed