Anesthesia, Atelectasis, Surgery--Complications
Conditions
Keywords
Anesthesia, AIR-test, Postoperative Pulmonary Complications
Brief summary
The overall objective of this study is to describe the incidence of postoperative pulmonary complications in patients with a positive and negative AIR-test result. Second, the investigators wish to describe the incidence of a positive AIR-test and its association with the development of PPC. In addition, the investigators aim to describe whether mechanical ventilation strategy differs between patients with a positive and negative AIR-test.
Detailed description
The 'AIR-test', a method wherein inspiratory oxygen concentration is reduced to 21% and pulse-oximetry hemoglobin saturation (SpO2) is monitored, can be used to demonstrate the presence of an atelectasis-induced alveolar shunt. It remains uncertain whether an intraoperative positive AIR-test is associated with clinical outcomes. It is hypothesized that in a general surgical population, the incidence of postoperative pulmonary complications (PPC) is higher in patients with a positive AIR-test than in patients with a negative AIR-test. The aim of this study is to describe the incidence of PPC in patients with a positive and in patients with a negative AIR-test. Second, the investigators want to describe the incidence of a positive AIR-test and its association with the development of PPC. The investigators also want to evaluate whether mechanical ventilation strategy differs between patients with a positive and negative AIR-test.
Interventions
PROCEDURESurgery
All types of surgery requiring general anesthesia
Sponsors
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 110 Years
Healthy volunteers
No
Inclusion criteria
* Patients undergoing surgery under general anesthesia in the Amsterdam University Medical Centers, location Meibergdreef with an Endotracheal Tube; * Patients \> 18 years; * Preoperative SpO2 of ≥97%; * AIR-test performed after induction of anesthesia, in a hemodynamic and respiratory steady state.
Exclusion criteria
* Age \< 18 years; * No consent/objection; * Patient participated in another conflicting interventional study on mechanical ventilation during general anesthesia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of postoperative pulmonary complications | The first 5 postoperative days | Respiratory failure; Bronchospasm; Acute Respiratory Distress Syndrome (ARDS); Suspected pulmonary infection; Aspiration pneumonitis; Atelectasis; Pleural effusion; Pulmonary infiltrate; Cardiopulmonary effusion; Pneumothorax |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tidal volume during general anesthesia for surgery | Intraoperative period | Tidal volume in mL per kg predicted bodyweight |
| Positive End-Expiratory Pressure during general anesthesia for surgery | Intraoperative period | Positive End-Expiratory Pressure in Centimeters of Water (cmH2O) |
| Peak Pressure during general anesthesia for surgery | Intraoperative period | Peak Pressure in cmH20 |
| Driving Pressure during general anesthesia for surgery | Intraoperative period | Driving Pressure in cmH2O |
| Fraction of Inspired Oxygen during general anesthesia for surgery | Intraoperative period | Fraction of Inspired Oxygen |
| AIR-test result | Intraoperative period | Number of patients with a positive and negative AIR-test |
| Respiratory Rate during general anesthesia for surgery | Intraoperative period | Respiratory Rate per minute |
| The incidence of the individual components of postoperative pulmonary complications | The first 5 postoperative days | Respiratory failure; Bronchospasm; ARDS; Suspected pulmonary infection; Aspiration pneumonitis; Atelectasis; Pleural effusion; Pulmonary infiltrate; Cardiopulmonary effusion; Pneumothorax |
| Length of hospital stay | From the day of surgery until the day of discharge, up to day 30 | Days of hospital stay |
| Rate of all-cause mortality and in-hospital mortality | Postoperative day 5 and postoperative day 30 | Mortality rate |
| End-tidal Carbon Dioxide (CO2) during general anesthesia for surgery | Intraoperative period | End-tidal CO2 in millimeters of mercury (mmHg) |
Countries
Netherlands
Outcome results
None listed