Hypoventilation, Hypoxemia, Postoperative Pulmonary Complications
Conditions
Keywords
hypoventilation, postoperative activity, abdominal surgery, mobilization, predicted minute ventilation (MVPred), accelerometer, chest monitor, postoperative pulmonary complications, surgical outcomes
Brief summary
This study plans to learn more about specific breathing and activity recommendations for patients after surgery. Participants will be monitored after abdominal surgery to identify what activities help them breathe better and reduce complications after surgery.
Detailed description
Investigators will study adults undergoing elective abdominal surgery with at least moderate risk for postoperative pulmonary complications. Participants will be monitored on their chest and thigh with devices that record their breathing pattern (breath volume and frequency) and body position and movements. These monitors will be placed on their skin in the Post-Anesthesia Care Unit (PACU) and will stay on for three days, or until the patient is able to ambulate freely or until their hospital discharge, whichever comes earlier. Investigators will analyze the association between the frequency, duration and intensity of various activities (e.g., sitting, walking) and breathing and other clinical complications, in combination with medications received and other hospital course events.
Interventions
DEVICEExSpiron and ActivPAL Monitors
ExSpiron chest monitor will be placed on the chest ActivPAL accelerometer will be placed on the chest and thigh
Sponsors
Brigham and Women's Hospital
University of Colorado, Denver
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Must be 18 or older * Must be undergoing abdominal surgery * Must be high-risk for PPCs (ARISCAT score equal to or greater than 26)
Exclusion criteria
* Anyone under 18 * Anyone not undergoing abdominal surgery * Anyone that is not high-risk for PPCs (ARISCAT score less than 26)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hypoventilation | First 3 postoperative days | Minutes per hour of hypoventilation which is defined as \<40% of a predicted minute ventilation volume |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of high TV | Through postoperative day 3 | Duration of high tidal volume (VT) |
| Variability of MV | Through postoperative day 3 | Variability of minute ventilation (MV) |
| Variability of VT | Through postoperative day 3 | Variability of tidal volume (VT) |
| Variability of RR | Through postoperative day 3 | Variability of respiratory rate (RR) |
| Events of Low MV | Through postoperative day 3 | Total number of events of low minute ventilation (MV) |
| Events of Low VT | Through postoperative day 3 | Total number of events of low tidal volume (VT) |
| Events of Low RR | Through postoperative day 3 | Total number of events of low respiratory rate (RR) |
| Percentage of time free of low or high MV | Through postoperative day 3 | The percentage of hours per day free of any low or high minute ventilation (MV) |
| Percentage of time free of low or high VT | Through postoperative day 3 | The percentage of hours per day free of any low or high tidal volume (VT) |
| Percentage of time free of low or high RR | Through postoperative day 3 | The percentage of hours per day free of any low or high resting rate (RR). |
| Duration of low MV | Through postoperative day 3 | Duration of low minute ventilation (MV) |
| Duration of low VT | Through postoperative day 3 | Duration of low tidal volume (VT) |
| Duration of low RR | Through postoperative day 3 | Duration of low respiratory rate (RR) |
| Duration of high MV | Through postoperative day 3 | Duration of low or high minute ventilation (MV) |
| Postoperative Pulmonary Complication (PPC) Incidence | Through postoperative day 7 | Incidence of Postoperative Pulmonary Complications, or PPCs |
| Duration of high RR | Through postoperative day 3 | Duration of high respiratory rate (RR) |
| Time After Surgery to Sitting | Through postoperative day 3 | Time it takes for the patient to sit in a chair after surgery |
| Time After Surgery to Ambulating | Through postoperative day 3 | Time it takes for the patient to ambulate with and without help |
| Total Minutes Walking | Through postoperative day 3 | Patient's total minutes of walking |
| Total Walking Distance | Through postoperative day 3 | Patient's total walking distance (in meters) |
| Frequency of Ambulation | Through postoperative day 3 | How many times the patient gets up to ambulate |
| Time Spent in Bed | Through postoperative day 3 | After the surgery, the patient's minutes spent in bed |
| Time Spent in Sitting | Through postoperative day 3 | After the surgery, the patient's minutes spent sitting |
| Time Spent Standing | Through postoperative day 3 | After the surgery, the patient's minutes spent standing |
| Time Spent Walking | Through postoperative day 3 | After the surgery, the patient's minutes spent walking |
| Average Speed of Ambulation | Through postoperative day 3 | After the surgery, the patient's average speed of ambulating |
| First Postoperative Day Achieving Independent Ambulation | Through postoperative day 3 | After the surgery, the patient's first day of ambulating by his or herself for 30 meters |
| Metabolic Equivalent of Task (MET) Score of Physical Activity | Through postoperative day 3 | After the surgery, the patient's intensity of physical activity measured in METs |
| Other complications | Through postoperative day 7 | Incidence of any non-respiratory complications |
| Adverse events | Through postoperative day 7 | Incidence of any adverse events |
| Postoperative Pulmonary Complication (PPC) Severity | Through postoperative day 7 | Postoperative Pulmonary Complications, or PPCs, will be observed in their severity. PPC severity is defined as the most serious from Grade 0 (none) to Grade 4 (severe) |
Countries
United States
Contacts
Primary ContactEmily G. Helmer
Outcome results
None listed