Atelectasis, Postoperative Pulmonary
Conditions
Keywords
Driving pressure, Positive end-expiratory pressure, Lung ultrasound
Brief summary
The purpose of this study is to investigate the effect of driving-pressure guided positive end-expiratory pressure (PEEP) titration.
Interventions
PROCEDURETitrated PEEP based on driving pressure
Alveolar recruitment and PEEP titration is performed at three time points: after intubation, after Trendelenburg, and after supine after CO2 deflation. The level of PEEP which makes the driving pressure lowest is selected and applied during the operation.
PROCEDUREConventional PEEP
Alveolar recruitment is performed at three time points: after intubation, after Trendelenburg, and after supine after CO2 deflation. Conventional PEEP (5cmH2O) is applied during the operation.
Sponsors
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients undergoing robot-assisted laparoscopic prostatectomy with Trendelenburg position
Exclusion criteria
* American Society of Anesthesiologists physical status IV or more * Severe cardiovascular disease * Severe chronic obstructive pulmonary disease, emphysema * History of pneumothorax, bullae * History of lung resection surgery * Conversion to laparotomy * Refusal to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Modified lung ultrasound score | 30 minutes after PACU administration | The score is calculated by adding up the 12 individual part scores assessed using lung ultrasound. The score for each part ranges from 0 to 3. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Modified lung ultrasound score | Intraoperative (at the end of operation before emergence) | The score is calculated by adding up the 12 individual part scores assessed using lung ultrasound. The score for each part ranges from 0 to 3. |
| Incidence of intraoperative desaturation | Intraoperative | Oxygen saturation by pulse oximetry\< 95% |
| Intraoperative partial pressure of arterial oxygen/fraction of inspired oxygen ratio | Intraoperative (30 minutes after designated PEEP applied) | Partial pressure of arterial oxygen/fraction of inspired oxygen ratio |
| Postoperative partial pressure of arterial oxygen/fraction of inspired oxygen ratio | 30 minutes after PACU administration | Partial pressure of arterial oxygen/fraction of inspired oxygen ratio |
| Postoperative pulmonary complications | After operation~ postoperative day 3 | Extubation failure, Fever, respiratory infection, respiratory failure, pleural effusion, atelectasis, pneumothorax, bronchospasm, aspiration pneumonitis, pneumonia |
Countries
South Korea
Outcome results
None listed