Obesity
Conditions
Keywords
obesity, steep trendelenburg, Trendelenburg, PEEP, positive end-expiratory pressure, EIT, electrical impedance tomography
Brief summary
The purpose of this study is to determine whether the Enlight 2100 electrical impedance tomography (EIT) belt can optimize positive end-expiratory pressure (PEEP) during surgery better than standard anesthesia machines.
Detailed description
Positive end-expiratory pressure (PEEP) is a measure taken intraoperatively to manage breathing during surgery. The Enlight 2100 is a device that uses electrical impedance tomography (EIT) to measure PEEP and provide a live image of the lungs while a patient is mechanically ventilated. In this study, the investigators will use the Enlight 2100 EIT belt to measure PEEP intraoperatively in order to better optimize PEEP settings for difficult cases.
Interventions
DEVICEPeep Belt
Belt will be placed on the nipple line of the patient prior to the surgery start in the operating room. Data will be collected prior to the initial incision after the patient has been intubated, and then at the end of surgery before the patient has been extubated.
Sponsors
University of Missouri-Columbia
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
Patients will be monitored by the standard of care anesthesia machines intraoperatively. An EIT belt will be attached to the patient intraoperatively, and data from the belt will be compared to the anesthesia machines.
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. BMI ≥ 40 kg/m2 2. Age \> 18 years 3. Scheduled for elective laparoscopic abdominal surgery in the steep Trendelenburg position. 4. Able to provide informed consent.
Exclusion criteria
1. Currently pregnant. 2. Presence of pacemaker, neurostimulator, spinal cord stimulator, or implantable cardioverter-defibrillator. 3. Skin ulcerations on upper torso near the belt placement. 4. Presence of phrenic nerve palsy or other diaphragm conditions. 5. Thoracic circumference \> 134 cm. 6. Tracheomalacia. 7. Inability to speak and understand English.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Optimal PEEP | From the time of consent to the end of surgery, assessed up to 24 hours. | Optimal positive end-expiratory pressure (PEEP) measured using the electrical impedance tomography (EIT) belt during surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Difference between EIT and standard of care measured PEEP | From the time of consent to the end of surgery, assessed up to 24 hours. | Measured difference between optimal positive end-expiratory pressure from the study device and the standard of care anesthesia machines. |
| Delays in extubation | From the day of surgery to discharge, up to 1 week | Number of delays in extubating the patient due to breathing complications during surgery. |
| Incidence of extubation complications | From the day of surgery to discharge, up to 1 week | Number of reintubations needed and/or failed extubations after surgery. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORTinashe Maduke, MD, MPH
University of Missouri-Columbia
Outcome results
None listed