Monitoring Lung Recruitment Maneuver in Anesthetized Morbidly Obese

Non-invasive Assessment of Lung Recruitment in Morbid Obese Patients Undergoing Bariatric Surgery

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT03694665

Enrollment

Registered

2018-10-03

Start date

2016-09-11

Completion date

2018-05-17

Last updated

2019-02-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Atelectasis

Keywords

airways pressure, mechanical ventilation, Atelectasis

Brief summary

Morbid obese patients present changes in respiratory physiology caused by weight overload. Intraoperative atelectasis is a pulmonary complication that affects not only gas exchange but also respiratory mechanics. The present study was aimed to test the role of different parameters for monitoring the treatment of atelectasis by a lung recruitment maneuver.

Detailed description

This is a prospective study perform in 30 anesthetized morbidly obese undergoing bariatric surgery. Lung mechanics and volumetric capnography will be non-invasively assessed during laparoscopy. Esophageal pressure will be measured by an esophageal balloon to measure transpulmonary pressure. A lung recruitment maneuver will be done. The optimum level of positive end-expiratory pressure (PEEP) is defined as the PEEP level when transpulmonary pressure remains positive during the PEEP titration trial of the recruitment maneuver. Lung collapse is detected when transpulmonary pressure becomes negative. The behavior of the studied volumetric capnography and lung mechanics parameters will be compared with the reference transpulmonary pressure signal.

Interventions

OTHERLung recruitment maneuver

A Lung recruitment maneuver is aimed to resolve atelectasis during mechanical ventilation. It consists in a brief and controlled increment in airways pressure using pressure control ventilation. Positive end-expiratory pressure (PEEP) is increases every 5 centimeters of water (cmH2O), from 0 to 20 cmH2O keeping a fixed driving pressure of 20 cmH2O. A final step of 40 cmH2O of plateau pressure was maintained for 10 breaths, returning then to standard ventilatory settings.

Study design

Allocation

Intervention model

SINGLE_GROUP

Primary purpose

DIAGNOSTIC

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to 65 Years

Healthy volunteers

Inclusion criteria

* Body mass index (BMI) \> 40 kg/m2 * Written inform consent * Scheduled for bariatric surgery * American Society of Anesthesia physical status II-III

Exclusion criteria

* Acute pulmonary disease * Emergency surgery

Design outcomes

Primary

Measure	Time frame	Description
Measurement of the optimum positive end-expiratory pressure in anesthetized morbidly obese patients	intraoperative	Comparison between a reference method (esophageal balloon) with volumetric capnography.

Countries

Argentina

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026