Electrical Impedance Tomography, Inhomogeneous Ventilation, Mechanical Ventilation, Neurosurgery
Conditions
Brief summary
Inhomogeneous ventilation was more likely to happen in patients after general anesthesia. Inhomogeneous ventilation may associate with ventilator-induced lung injury. A large number of post-neurosurgical patients was delayed extubation and received mechanical ventilation, so that, inhomogeneous ventilation was more likely to happen in the population. Electrical impedance tomography (EIT) is an noninvasive, radiation-free, high temporal resolution, relatively cheap technique in monitoring ventilation distribution bedside. The investigators aimed to investigate the incidence of inhomogeneous ventilation and factors associated with inhomogeneous ventilation in post-neurosurgical patients under mechanical ventilation.
Detailed description
Inhomogeneous ventilation was more likely to happen in patients after general anesthesia. Inhomogeneous ventilation may associate with ventilator-induced lung injury since the gravity-depend collapse and over-distention of nondependent regional in patients under mechanical ventilation. A large number of post-neurosurgical patients was delayed extubation and received mechanical ventilation, so that, inhomogeneous ventilation was more likely to happen in the population. Up to now, there is no research reported about the prevalence of inhomogeneous ventilation and the factors associated with inhomogeneous ventilation in post-neurosurgical patients, in present study, The investigators prospectively enrolled adult patients after neurosurgical operations. Electrical impedance tomography (EIT) is an noninvasive, radiation-free, high temporal resolution, relatively cheap technique in monitoring ventilation distribution bedside. The investigators aimed to investigate the incidence of inhomogeneous ventilation and factors associated with inhomogeneous ventilation in post-neurosurgical patients under mechanical ventilation.
Interventions
None listed
Sponsors
Capital Medical University
Study design
Observational model
OTHER
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Undergoing elective neurosurgery operation * Trachea intubated and mechanical ventilated
Exclusion criteria
* Age under 18 years-old * Unstable hemodynamics patients (mean arterial pressure under 65mmHg) after pharmacotherapy * History of chronic obstructive pulmonary disease(COPD) or asthma * Contraindication of using EIT (pacemaker, defibrillator, and implantable pumps) * Unable to install EIT belt (skin infection, wound) * Incompleteness of thorax (e.g. pneumothorax, rib fracture and etc.) or malformation of thorax.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of inhomogeneous ventilation | within 24 hours after neurosurgical operative | In supine position, global image of EIT was divided into upper and lower part, each part accounting for 50%, which was named as non-dependent region and dependent region respectively. Inhomogeneous ventilation was defined as the ratio between tidal impedance variation of dependent region(VTdep) and global tidal impedance variation (VT) is less than 45% during stable Spontaneous breath, which was defined as variation of tidal volume less than 10% in continuous 6 breathes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of postoperative pulmonary complications(PPCs) | 28 days after neurosurgical operative | Postoperative pulmonary complication was defined as follows: Pneumonia was defined as recent pulmonary infiltration on chest radiography associated with at least 2 of the following signs: purulent tracheobronchial secretion, a body temperature \> 38.3℃，and leukocytes in peripheral blood \> 25% above the basal count. Tracheobronchitis was an increase in the volume or a change in the color or purulent aspect of tracheobronchial secretion with a normal chest radiograph. Atelectasis was evidence on chest radiography of pulmonary atelectasis associated with acute respiratory symptoms. Bronchoconstriction was classified as the presence of wheezing associated with acute respiratory symptoms with a good response to inhalatory bronchodilator medication. |
| Length of ICU stay | through study completion, an average of 7 days | The number of days that patients stay in ICU. |
| Length of hospital stay | through study completion, an average of 28 days | The number of days that patients stay in hospital. |
Countries
China
Contacts
Primary ContactJian-Xin Zhou, MD
Outcome results
None listed