Ventilator-Induced Lung Injury
Conditions
Keywords
trendelenburg, robot-assisted laparoscopic surgery
Brief summary
In this study, changes in new oxygenation indices investigated by Asar et al. will be compared with conventional oxygenation and saturation indices in patients undergoing robot-assisted laparoscopic surgery due to pneumoperitoneum and Trendelenburg position.
Detailed description
During the intraoperative period, optimal oxygenation should be achieved while avoiding the harmful effects of hypoxia and hyperoxia in patients. The PaO2/FiO2 and SpO2/FiO2 ratios have been traditionally used to assess this condition. Subsequently, oxygenation indices incorporating mean airway pressure have been developed, such as the oxygenation index (OI = (FiO2 × Pmean) / PaO2) and oxygenation saturation index (OSI = (FiO2 × Pmean) / SpO2). More recently, Asar et al. have defined 8 novel oxygenation indices using mean power (MP) and driving pressure (DP) instead of Pmean (OSI-MPtot, OI-MPtot, OSI-ΔPinsp, OI-ΔPinsp, OSI-MPdyn, OI-MPdyn, PaO2/(FiO2xPEEP), and SpO2/FiO2xPEEP). They compared the predictive power of these new indices for intensive care unit (ICU) mortality in COVID-ARDS (C-ARDS) patients with conventional oxygenation indices (PaO2/FiO2, SpO2/FiO2, OI, OSI). OI-ΔPinsp, OSI-ΔPinsp, and OSI-MPdyn indices were found to have the highest predictive power for ICU mortality. However, there is currently no study investigating the changes of these new indices during the intraoperative period.
Interventions
PROCEDURET1
Arterial blood gas was obtained immediately after pneumoperitoneum in trendelenburg position. Ventilator parameters and hemodynamic parameters were recorded.
PROCEDURETint Time
Arterial blood gas was obtained immediately after intubation(Tint) in supine position. Ventilator parameters and hemodynamic parameters were recorded.
PROCEDURET0 Time
Arterial blood gas was obtained immediately after pneumoperitoneum in trendelenburg position. Ventilator parameters and hemodynamic parameters were recorded.
Sponsors
Başakşehir Çam & Sakura City Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* ASA (American Society of Anesthesiologists) class I-III * Age between 18-75 years * Signed informed consent form
Exclusion criteria
* Diagnosis of COPD (Chronic Obstructive Pulmonary Disease) and asthma * History of thoracic surgery * Body mass index (BMI) \> 35 * Development of hemodynamic instability or desaturation (SpO2 \< 92) during the operation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oxygenation indices | during the surgery and immediately after the surgery (approximately 3 hours to 6 hours) | This study aims to investigate the effects of Trendelenburg position and pneumoperitoneum OSI-MPtot in ASA I-III patients undergoing robot-assisted laparoscopic surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mechanical ventilator parameters | during the surgery and immediately after the surgery (approximately 3 hours to 6 hours) | Change in PEEP (cmH2O) with Trendelenburg position and pneumoperitoneum |
| Arterial blood gas parameters | during the surgery and immediately after the surgery (approximately 3 hours to 6 hours) | Change in the pH with Trendelenburg position and pneumoperitoneum |
| Hemodynamic parameters | during the surgery and immediately after the surgery (approximately 3 hours to 6 hours) | Change in the heart rate with Trendelenburg position and pneumoperitoneum |
Countries
Turkey (Türkiye)
Outcome results
None listed