Airway Management, Atelectasis, General Anesthesia, Mechanical Ventilation, Postoperative Hypoxemia, Postoperative Respiratory Complications, Tracheal Extubation
Conditions
Keywords
Tracheal Extubation, Positive Pressure Extubation, Positive End-Expiratory Pressure (PEEP), Airway Management, Postoperative Desaturation, Postoperative Hypoxemia, Atelectasis, Mechanical Ventilation, General Anesthesia, Respiratory Complications, Post-Anesthesia Care Unit (PACU), Adult Surgery
Brief summary
Evaluation of a postoperative tracheal extubation protocol under positive pressure in accordance with international recommendations. Two arms: the first with "classic" extubation with disconnection of the respirator and the second with extubation without disconnection of the respiratory, as recommended. Computer Randomization with a 1: 1 ration
Interventions
PROCEDUREpositive pressure extubation
Two arms: the first with "classic" extubation with disconnection of the ventilator and the second with an extubation without disconnection of the respiratory "positive pressure"
Sponsors
University Hospital, Rouen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age\> 18 and \<80 * Patient going to benefit from general anesthesia with orotracheal intubation for surgery lasting more than 60 minutes at the visceral surgery unit of the Rouen University Hospital. * Person affiliated to a social security scheme * Person who has read and understood the newsletter and signed the consent form
Exclusion criteria
* Minor patients or age\> 80 years * History of Obstructive Sleep Apnea Syndrome * Chronic respiratory failure / History of chronic obstructive pulmonary disease * Surgery \< 60 minutes * Use of methylene blue intraoperatively * Extubation finally performed in the operating room * orotracheal intubation difficult to induce general anesthesia * Suspected inhalation during orotracheal intubation * Pneumothorax per operative * Heart failure authenticated by trans thoracic ultrasound \<50% * Neuromuscular pathologies (myasthenia gravis, myopathies) * Body mass index\> 35 * Emergency surgery * Patient with an ASA IV score (ie according to the definition of the American Society of Anesthesiology) * Major surgical complications (hemorrhagic shock) * Major anesthetic complications (anaphylactic shock, bronchospasm) * Pregnant or parturient or lactating woman or woman of childbearing age without proven contraception * Person deprived of their liberty by an administrative or judicial decision or person placed under the protection of justice / guardianship or curatorship
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Desaturation rate | within one hour of tracheal extubation | defined by a SpO2 \< 92% |
Countries
France
Outcome results
None listed