Cancer of Head and Neck, Tracheostomy, Postoperative Pulmonary Complication, Surgery
Conditions
Keywords
Postoperative pulmonary complication, Lung ultrasound, Tracheostomy, ENT cancer surgery
Brief summary
After ENT cancer surgery, postoperative respiratory complications are common, especially after tracheostomy. The objective of this study is to characterize the pulmonary status of patients after ENT cancer surgery. We wish to collect and analyze the pulmonary abnormalities revealed by the ultrasound scans performed in the post-anesthesia care unit (PACU), at day 1 and at day 2 after ENT cancer surgery with tracheostomy.
Detailed description
After ENT cancer surgery, postoperative respiratory complications are common, especially after tracheostomy. Problems with lung ventilation called atelectasis are largely associated with these complications. These atelectasis develop within minutes of the start of general anesthesia. Patients who develop a complication require longer postoperative oxygen treatment and more physical therapy. The diagnosis of atelectasis can be made by standard chest radiography, which is a source of radiation and requires moving the patient. An alternative technique, lung ultrasound, is a non-irradiating examination that can be performed in the patient's bed. It is routinely performed in the postoperative surveillance room and in the intermediate care unit at the Centre Léon Bérard. The objective of this study is to characterize the pulmonary status of patients after ENT cancer surgery. We wish to collect and analyze the pulmonary abnormalities revealed by the ultrasound scans performed in the post-anesthesia care unit (PACU), at day 1 and at day 2 after ENT cancer surgery with tracheostomy.
Interventions
DIAGNOSTIC_TESTLung ultrasound score
To evaluate the incidence of pulmonary atelectasis in the post-anesthesia care unit (PACU) using lung ultrasound.
Sponsors
Centre Leon Berard
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ENT cancer surgery with tracheostomy or tracheotomy
Exclusion criteria
* under 18 years old * deprivation of liberty * pre-existing tracheotomy or tracheostomy * patient refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Lung ultrasound score, in the PACU after ENT cancer surgery. | Up to 24 hours | Lung ultrasound score : Images were obtained in PACU. Care was taken to set the focal zone on the pleural line. The thorax was divided into 12 quadrants: anterior, lateral, and posterior zones (separated by the anterior and posterior axillary lines) each divided in upper and lower portions for the right and left lung. Intercostal spaces of each of these areas were scanned and a cine-loop of the most pathologic area of each quadrant was saved to digital format. A semiquantitative score, the lung ultrasound (LUS) score, was calculated to assess lung aeration at each time point as described by Monastesse. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Lung ultrasound score, on day 1 after ENT cancer surgery. | on the 1st day after surgery | Lung ultrasound score : Images were obtained on day 1 after PACU (in intermediate care unit). Care was taken to set the focal zone on the pleural line. The thorax was divided into 12 quadrants: anterior, lateral, and posterior zones (separated by the anterior and posterior axillary lines) each divided in upper and lower portions for the right and left lung. Intercostal spaces of each of these areas were scanned and a cine-loop of the most pathologic area of each quadrant was saved to digital format. A semiquantitative score, the lung ultrasound (LUS) score, was calculated to assess lung aeration at each time point as described by Monastesse. |
| To assess the incidence of pulmonary atelectasis in the PACU by chest radiography. | Up to 24 hours | pulmonary atelectasis on chest radiography |
| Study gas exchange in PACU | up to 24 hours | SpO2/FiO2 |
| Lung ultrasound score, on day 2 after ENT cancer surgery. | on the 2nd day after surgery | Lung ultrasound score : Images were obtained on day 2 after PACU (in intermediate care unit). Care was taken to set the focal zone on the pleural line. The thorax was divided into 12 quadrants: anterior, lateral, and posterior zones (separated by the anterior and posterior axillary lines) each divided in upper and lower portions for the right and left lung. Intercostal spaces of each of these areas were scanned and a cine-loop of the most pathologic area of each quadrant was saved to digital format. A semiquantitative score, the lung ultrasound (LUS) score, was calculated to assess lung aeration at each time point as described by Monastesse. |
| Study gas exchange on day 2 after surgery | on the 2nd day after surgery | SpO2/FiO2 |
| incidence of postoperative respiratory complications in the month following ENT cancer surgery (eg number of participants with a postoperative respiratory complication) | up to 31 days | number of participants who had a postoperative respiratory complication within 30 days of surgery: atelectasis, pulmonary oedema, consolidation, pneumothorax, pleural effusion, bronchospasm, pneumonia. |
| Study gas exchange on day 1 after surgery | on the 1st day after surgery | SpO2/FiO2 |
Countries
France
Contacts
Primary ContactGrégoire Wallon, MD
Outcome results
None listed