Anesthesia, Mechanical Ventilation Complication, Postoperative Complications
Conditions
Keywords
Anesthesia, Pulmonary postoperative complications, ALPE, Ventilation/perfusion mismatch
Brief summary
Pulmonary postoperative complications (PPC) are among the main causes of surgical complications affecting both postoperative morbidity and mortality. Little is known about the effect of intraoperative VQ mismatch on the occurrence of PPC. In this trial the investigators will evaluate if intraoperative VQ mismatch may predict PPC in a population of patients undergoing major surgery.
Detailed description
Pulmonary postoperative complications (PPC) are among the main causes of surgical complications affecting both postoperative morbidity and mortality. Little is known about the effect of intraoperative VQ mismatch on the occurrence of PPC. PPC are classically considered associated to the occurrence of intraoperative atelectasis, and therefore to the development of a certain amount of shunt, but this concept have been recently questioned. Recent studies showed indeed that, despite age is one of the main determinants of PPCs, increasing age is not associated to the increase of intraoperative shunt. Shunt therefore may not be the main determinant of PPC. In this trial the investigators will evaluate if other causes of intraoperative VQ mismatch (e.g. low V/Q, high V/Q, dead space) may predict PPC in a population of patients undergoing major surgery.
Interventions
DEVICEMeasure of ventilation/perfusion (V/Q) mismatch using Beacon ALPE (Automatic Lung Paramether Estimator)
Evaluation of intraoperative V/Q mismatch using the Beacon ALPE during anesthesia.
Sponsors
Aalborg University
Università degli Studi di Ferrara
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Age 18-90 years * Major elective surgery with general anesthesia * Intraoperative cannulation of the radial artery for invasive pressure monitoring
Exclusion criteria
* Thoracic surgery with one lung ventilation * Refuse to participate * Emergency surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Occurrence of Pulmonary postoperative complications | In the first 7 days after surgery | Definition derived from the ESA-ESICM joined taskforce on perioperative outcome measures. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative drug administration | During surgery | Evalation of anesthetic drugs administered during surgery by the treating physician. |
| Intraoperative arterial pressure | During surgery | Evaluation during surgery of: * systolic pressure (mmHg) * diastolic pressure (mmHg) |
| Intraoperative mechanical measures (pressures) | During surgery | Intraoperative evaluation of: * Peak pressure (Ppeak), cmH2O * Plateau pressure (Pplat), cmH2O * Total PEEP (PEEP total), cmH2O |
| V/Q mismatch | During anesthesia | Evaluation of V/Q mismatch |
| fluid balance | During surgery | Evaluation of patients fluid intake and fluid balance during surgery |
| Intraoperative heart rate | During surgery | evaluation of \- Heart rate (beats/min) |
Countries
Italy
Outcome results
None listed