Optimal Positive End-expiratory Pressure (PEEP) in Prone Position During Spine Surgery. A Prospective Observational Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Anesthesia
- Sponsor
- Parc de Salut Mar
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Change in Positive End-Expiratory Pressure (PEEP)
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
Background:
There is a lack of studies regarding Optimal (best) positive end-expiratory pressure (PEEP) in prone position during surgery, and its relation with optimal PEEP in supine position.
Hypothesis:
In patients undergoing scheduled spinal surgery, optimal PEEP in the prone position is lower than optimal PEEP in the supine position.
Aims:
To assess the difference optimal PEEP in supine vs. prone positions in patients undergoing spine surgery.
To evaluate the changes in optimal PEEP in prone position throughout the surgical procedure.
Methods:
Observational study, one center. Main variable: optimal PEEP. Secondary variables: PaO2, pCO2 and dynamic compliance (Crd) in prone and supine position.
Detailed Description
Recruitment: Patients scheduled for spine surgery were Main outcome: Optimal PEEP determined after a pulmonary recruitment manoeuvre in supine and in prone position and every hour during the surgery in prone position. Secondary outcomes: Pulmonary compliance, blood gas analysis and hemodynamic parameters
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age ≥18 years.
- •Spine prone surgery lasting ≥2 hours.
- •Absence of known pulmonary pathology.
Exclusion Criteria
- •Pregnancy or lactation.
- •Contraindication to alveolar recruitment maneuvers (risk of barotrauma, hemodynamic instability).
- •Body mass index (BMI) \>
- •Heart failure defined as IC \<2.5 L/min/m2 and/or inotropic support requirements prior to surgery.
- •Diagnosis or suspicion of intracranial hypertension (intracranial pressure \>15 mmHg).
Outcomes
Primary Outcomes
Change in Positive End-Expiratory Pressure (PEEP)
Time Frame: From determination of optimal PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours)
Variation of Positive End-Expiratory Pressure (cmH2O) during surgery in prone position with respect to PEEP value at 10 minutes after positioning
Positive End-Expiratory Pressure (PEEP)
Time Frame: 10 minutes after positioning
Positive End-Expiratory Pressure (cmH2O) in prone position
Secondary Outcomes
- Arterial oxygen pressure (PaO2)(10 minutes after positioning)
- Change in static compliance(Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours))
- Arterial carbon dioxide pressure (PaCO2)(10 minutes after positioning)
- Change in arterial carbon dioxide pressure (PaCO2)(Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours))
- Static compliance(10 minutes after positioning)
- Change in arterial oxygen pressure (PaO2)(Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours))