Ventilation Strategy for the Elderly Patients in Prone Position

Modification of Ventilation Strategy for the Elderly Patients During Spine Surgery in Prone Position

Status

UNKNOWN

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT04520893

Enrollment

Registered

2020-08-20

Start date

2020-10-22

Completion date

2021-03-31

Last updated

2021-02-18

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

Conditions

Ventilators, Mechanical

Keywords

geriatric medicine, protective ventilation, prone position

Brief summary

The investigators compare three ventilation modes; volume controlled ventilation, volume guaranteed pressure controlled ventilation and volume controlled ventilation with pause during spine surgery for the elderly patients. The investigators can reveal that how lung collapse can be reduced by optimizing the inspiratory flow pattern under general anesthesia.

Detailed description

\<Protocol\> 1. All patients were ventilated by an anaesthesia ventilator (Zeus, Dräger, Lübeck, Germany) under general anesthesia. 2. Ventilation strategy: * Pressure controlled ventilation volume guaranteed (PCV-VG) mode or volume control ventilation (VCV) mode * tidal volume 6-8 mL/kg (predicted body weight) * Inspiratory/expiratory (I/E) ratio 1:1.5 * Inspired oxygen concentration (FIO2) 0.5 with air * 3.0 L/min of inspiratory fresh gas flow * Positive end-expiratory pressure (PEEP) of 5 cm H2O * Respiratory rate (RR) of 10 to 14 min-1 3. After prone positioning and hemodynamic condition was stabilized, patients were ventilated with VCV, PCV-VG mode, VCV with pause following a randomized order, previously determined for each patient. Before each ventilator setting was started, lung recruitment maneuvers were performed to set the lungs to a defined baseline status. * ventilation order : one of the following examples is taken by randomization. VCV 15 min -- VCV pause 15min -- PCV-VG 15min VCV 15 min -- PCV-VG 15min -- VCV pause 15min VCV pause 15min -- VCV 15 min -- PCV-VG 15min VCV pause 15min -- PCV-VG 15min -- VCV 15 min PCV-VG 15min -- VCV 15 min -- VCV pause 15min PCV-VG 15min -- VCV pause 15min -- VCV 15 min

Interventions

PROCEDUREventilator setting vcv with pause

ventilator setting vcv with pause

PROCEDUREventilator setting vcv

ventilator setting vcv without pause

PROCEDUREventilator setting pcv-vg

ventilator setting with pcv-vg

Study design

Allocation

RANDOMIZED

Intervention model

CROSSOVER

Primary purpose

SUPPORTIVE_CARE

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

65 Years to 85 Years

Healthy volunteers

Inclusion criteria

* patients undergoing elective spine surgery under general anesthesia

Exclusion criteria

* obesity (body mass index \>35 kg/m2) * chronic obstructive pulmonary disease * respiratory infection

Design outcomes

Primary

Measure	Time frame	Description
MVCO2	ventilation 15 min later	minute CO2 production (ml/min), a parameter of Drager ventilator, displayed in the Primus model and software

Secondary

Measure	Time frame	Description
airway pressure	ventilation 15 min later	peak airway pressure (cmH2O; displayed in the ventilator), plateau pressure (cmH2O; diaplayed in the ventilator), driving pressure(cmH2O, plateau pressure minus peak airway pressure)
airway compliance	ventilation 15 min later	Respiratory dynamic compliance (ml/cmH2O; displayed in the ventilator)

Countries

South Korea

Outcome results

None listed

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