Intraoperative Ventilation, Respiratory Mechanics
Conditions
Keywords
PRVC ventilation, Laparoscopic surgery, Peak airway pressure, Dynamic compliance, General anesthesia, Mechanical ventilation
Brief summary
This study aims to evaluate peak airway pressure and respiratory mechanics during pressure-regulated volume control (PRVC) ventilation in patients undergoing elective laparoscopic abdominal surgery. Pneumoperitoneum and patient positioning during laparoscopic procedures can significantly affect respiratory mechanics, including airway pressures and lung compliance. The study will assess changes in peak airway pressure, dynamic compliance, and other ventilatory parameters during different intraoperative phases. The findings are expected to provide insights into optimizing ventilatory strategies to improve patient safety and minimize ventilator-associated complications during laparoscopic surgery.
Detailed description
Laparoscopic abdominal surgery requires the creation of pneumoperitoneum, which increases intra-abdominal pressure and affects respiratory system mechanics. These changes can lead to increased peak airway pressure and reduced lung compliance, potentially increasing the risk of ventilator-induced lung injury. Pressure-regulated volume control (PRVC) ventilation is designed to deliver a set tidal volume with the lowest possible airway pressure by adjusting inspiratory pressure dynamically. However, its performance during laparoscopic procedures and its effect on respiratory mechanics require further evaluation. This prospective observational study will be conducted on adult patients undergoing elective laparoscopic abdominal surgery under general anesthesia. Standardized anesthesia and ventilation protocols will be applied. Respiratory parameters including peak airway pressure, tidal volume, respiratory rate, and dynamic compliance will be recorded at predefined time points: after induction, after pneumoperitoneum, and at steady-state intraoperative conditions. The primary outcome will be peak airway pressure. Secondary outcomes include dynamic compliance and other ventilatory parameters. The study aims to enhance understanding of respiratory mechanics during PRVC ventilation and support evidence-based optimization of intraoperative ventilation strategies.
Interventions
OTHERPRVC Ventilation
Mechanical ventilation using pressure-regulated volume control mode applied as part of routine intraoperative anesthesia care. No experimental intervention is introduced.
Sponsors
Specialized Medical Center (SMC)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adult patients aged 18-65 years * Scheduled for elective laparoscopic abdominal surgery under general anesthesia * ASA physical status I-II * Patients requiring mechanical ventilation using PRVC mode * Provided informed consent
Exclusion criteria
* Patients with significant cardiopulmonary disease * Chronic obstructive pulmonary disease or restrictive lung disease * Morbid obesity (BMI \> 35 kg/m²) * Pregnancy * Emergency surgeries * Patients with anticipated difficult airway * Refusal to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peak Airway Pressure | At 0, 5, and 10 minutes intraoperatively | Peak airway pressure (PIP) measured intraoperatively using the anesthesia workstation under standardized pressure-regulated volume control ventilation settings. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dynamic Compliance | At 0, 5, and 10 minutes intraoperatively | Dynamic lung compliance (Cdyn) measured intraoperatively using standard anesthesia monitoring at predefined time points. |
| Plateau Pressure | At 0, 5, and 10 minutes intraoperatively | Plateau pressure (Pplat) measured during controlled ventilation using the anesthesia workstation. |
| End-tidal Carbon Dioxide | At 0, 5, and 10 minutes intraoperatively | End-tidal carbon dioxide (EtCO2) measured continuously during mechanical ventilation. |
| Mean Airway Pressure | At 0, 5, and 10 minutes intraoperatively | Mean airway pressure measured intraoperatively using the anesthesia workstation. |
| Oxygen Saturation | At 0, 5, and 10 minutes intraoperatively | Peripheral oxygen saturation (SpO2) monitored continuously during surgery. |
| Heart Rate (beats/min) | At 0, 5, and 10 minutes intraoperatively | Heart rate measured intraoperatively using standard monitoring |
| Mean Arterial Pressure (mmHg) | At 0, 5, and 10 minutes intraoperatively | Mean arterial pressure measured intraoperatively using standard monitoring |
| Minute Ventilation | At 0, 5, and 10 minutes intraoperatively | Minute ventilation recorded from the anesthesia workstation during controlled ventilation. |
Contacts
CONTACTSalaheldin A Abdelaziz Ahmed, MD
PRINCIPAL_INVESTIGATORSalaheldin A Abdelaziz Ahmed, MD
Specialized Medical Center (SMC), Riyadh, Saudi Arabia
Outcome results
None listed