Impact of Lung Recruitment Maneuvers on Driving Pressure in Cardiac Surgery

Completed

• Conditions: Anesthesia, General; Respiration, Artificial; Lung Diseases; Atelectasis; Cardiac Surgical Procedures

• Registration Number: NCT03976947
• Lead Sponsor: University Hospital, Caen

Brief Summary

In anesthesia the incidence of postoperative pulmonary complications is frequent, especially in cardiac surgery where the incidence can reach 10%. Respiratory morbidity in cardiac surgery is favored by multiple factors and is higher compared to anesthesia in "general" surgery. The prevention of these complications is a major challenge in the management of patients.

Influence of driving pressure level on respiratory morbidity was first demonstrated in management of acute respiratory distress syndrome (ARDS) in resuscitation.

More recently, this notion has been introduced in anesthesia, with a correlation between increase driving pressure level and increase of post-operative respiratory complications.

A method should reduce these levels of driving pressure: performing lung recruitment maneuvers. This technique has been successfully tested in abdominal surgery in particular in a study published by Futier et al.. They systematized and standardized lung recruitment maneuvers and showed a decrease of postoperative pulmonary complications in abdominal surgery.

Thus, the realization of lung recruitment maneuvers, already used at the discretion of the practitioner, is now recommended by several teams of experts. The investigators propose in this "before-after" trial to evaluate variation in driving pressure due to systematic use of lung recruitment maneuvers, observed in patients operated in elective or urgent surgery. The secondary objective is to evaluate their impact on postoperative pulmonary complications.

Detailed Description

This is a retrospective, before / after, monocentric trial.

Study Timeline

• Study First Submitted: 2017-04-14
• Study Start: 2017-05-01
• Primary Completion: 2018-01-30
• Study Completion: 2018-02-28
• Status Verified: 2019-06
• Study First Submitted QC: 2019-06-05
• Study First Posted: 2019-06-06
• Last Update Submitted: 2020-01-17
• Last Update Posted: 2020-01-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 217

Inclusion Criteria

• Patients receiving elective or urgent cardiac surgery with cardiopulmonary bypass

Exclusion Criteria

• Emergency or salvage surgery
• Patient under guardianship
• Pregnancy

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Driving pressure variation due to lung recruitment maneuvers	1 day	cmH2O

Secondary Outcome Measures

Name	Time	Method
Incidence of postoperative pulmonary complications	baseline	percentage

Trial Locations

Locations (1)

Caen University Hospital; 🇫🇷 Caen, France