Diaphragm Issues, Neurosurgery, Pulmonary Complication
Conditions
Keywords
Neurosurgery, Respiratory muscle dysfunction, Diaphragm, Expiratory muscle, Post operative pulmonary complications
Brief summary
Respiratory muscle dysfunction may contribute to the development of postoperative pulmonary complications. However, it prevalence in patients receiving neurosurgery is largely unknown. Therefore, in present study, respiratory muscle function (measured by the ultrasound) and their correlation with the post-operative pulmonary complications will be analyzed.
Detailed description
Postoperative pulmonary complications is common in patients receiving neurosurgery, and is associated with hospitalization cost and mortality. Respiratory muscle dysfunction is an important cause postoperative pulmonary complications, however, it's prevalence in patients receiving neurosurgery is unclear. The diaphragm and abdominal expiratory muscles are the main inspiratory and expiratory driving muscles. Ultrasound can assess the function and morphology of these muscles invasively and in realtime. Studies has demonstrated their feasibility and repeatability in realtime monitoring of respiratory muscles. In this study, our primary aim is to assess the respiratory muscle function after neurosurgery, and the correlation between diaphragm and expiratory muscle function. Our secondary aims including the correlation between the brain injury and the respiratory muscle function, and the impact of post-operative respiratory muscle dysfunction on the pulmonary complications.
Interventions
DIAGNOSTIC_TESTMaximum inspiratory/Expiratory manoeuvre for patients can follow the order
Bedside ultrasound will be performed for each patient at the time before, after surgery, before and after extubation, and at the time of ICU discharge, under the end-expiratory occlusion, maximum inspiratory, and/or expiratory manoeuvre
Sponsors
Beijing Sanbo Brain Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Informed consent * First elective operation during hospitalization * ASA\<3
Exclusion criteria
* Brain stem and spinal spine lesions * Preoperative chest imaging findings were abnormal * Mechanical ventilation was required before surgery * Clinical or radiological evidence of preoperative misaspiration * History of neurosurgery in the last 6 months * A history of neuromuscular disease * BMI≥35kg/m2 * Pregnant women * Skin lesions detected by ultrasound
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of diaphragm dysfunction after neurosurgery | Within 24 hours after the completion of surgery | The diaphragm dysfunction is defined as the thickening fraction \< 20% under the maximum inspiration |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The correlation between the level of inflammation maker ILs and the diaphragm function | Within 24 hours after the completion of surgery | The level of ILs are measured in the blood sample within 24 hours after surgery |
| The correlation between the level of inflammation maker TNF-alpha and the diaphragm function | Within 24 hours after the completion of surgery | The level of TNF-alpha is measured in the blood sample within 24 hours after surgery |
| The thickening fraction of expiratory muscles after surgery | Within 24 hours after the completion of surgery | the thickening fraction of expiratory muscle is measured under the maximum expiration maneuver |
| The incidence of postoperative pulmonary complication | Through study completion, an average of 1 month | The postoperative pulmonary complication is defined as when patient has developed one or more complications including pneumonia, atelectasis, pulmonary edema, pulmonary embolism, or respiratory failure |
| The correlation between the level of NSE and the diaphragm function | Within 24 hours after the completion of surgery | The level of NSE is measured in the blood sample within 24 hours after surgery |
| The length of ICU stay | Through study completion, an average of 1 month | The length of ICU stay is counted by day |
| Duration of mechanical ventilation | Through study completion, an average of 1 month | The duration of mechanical ventilation is counted by hours |
| Hospital mortality | Through study completion, an average of 1 month | The hospital mortality is recorded at the time of discharge |
| The length of hospital stay | Through study completion, an average of 1 month | The length of hospital stay is counted by day |
Countries
China
Contacts
Primary ContactZhonghua Shi, PhD
Outcome results
None listed