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The Influence of Different PEEP Levels After Recruitment Maneuvre on the Effect of Alveolar Recruitment Maintenance and Patients' Cardiac Function

Not Applicable
Not yet recruiting
Conditions
Pulmonary Atelectasis
Registration Number
NCT07161466
Lead Sponsor
Northern Jiangsu People's Hospital
Brief Summary

During general anesthesia surgery, the role of positive end-expiratory pressure (PEEP) in mechanical ventilation remains uncertain. Pressure levels above 0 cm H₂O can prevent postoperative pulmonary complications but may also cause intraoperative circulatory depression and lung injury due to overdistension. Using very low levels of PEEP may lead to atelectasis. However, high levels of PEEP can not only trigger complications such as intraoperative circulatory depression but also promote hyperinflation. Positive end-expiratory pressure (PEEP) is required to prevent atelectasis during lung-protective ventilation, and different levels of PEEP exhibit varying physiological and clinical effects when used alone or in combination with alveolar recruitment maneuvers (ARM). Alveolar recruitment maneuvers (ARM) are used to open atelectatic lung parenchyma, but the duration of their benefits has not been clearly determined. This study aims to determine the effectiveness of different PEEP levels after ARM in general anesthesia surgery, the duration of their time-dependent responses, and their hemodynamic effects, providing a reference for how often recruitment maneuvers should be performed during general anesthesia and further refining the specific details of lung-protective ventilation strategies.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
96
Inclusion Criteria
  • ASA physical status classification: Ⅰ or Ⅱ or Ⅲ
  • Adults aged 18 to 80 years, regardless of gender.
  • Patients undergoing elective laparoscopic surgery under general anesthesia.
  • Patients who have provided written informed consent after understanding the study purpose, procedures, and potential risks.
Exclusion Criteria
  • Recent thoracic surgery; chest X - ray or CT indicating pneumothorax, emphysema, or pulmonary bullae;
  • Pulmonary diseases: asthma, severe obstructive ventilatory dysfunction; preoperative pulse oxygen saturation (SpO2) < 90% in room air or SpO2 < 95% with oxygen supplementation; contraindications for lung recruitment: high intracranial pressure, hypovolemic shock, right heart failure;
  • Severe heart disease (New York Heart Association, NYHA Class III or IV; acute coronary syndrome or sustained ventricular tachyarrhythmia); participation in other interventional studies or refusal to be enrolled.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
the duration of improvement in lung complianceduring the surgery
Secondary Outcome Measures
NameTimeMethod

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