Effect of Patient Position on Arterial, End-tidal and Transcutaneous Carbon Dioxide

Not Applicable

• Conditions: Ventilation Perfusion Mismatch
• Interventions: Other: Arterial carbon dioxide monitoring; Other: End-tidal carbon dioxide monitoring; Other: Transcutaneous carbon dioxide monitoring

• Registration Number: NCT03508791
• Lead Sponsor: SMG-SNU Boramae Medical Center

Brief Summary

Investigators evaluate the effect of patient position (Trendelenburg and reverse Trendelenburg) on arterial, end-tidal and transcutaneous carbon dioxide partial pressure in patients undergoing laparoscopic surgery.

Detailed Description

Investigators evaluate the effect of patient position (Trendelenburg and reverse Trendelenburg) on arterial, end-tidal and transcutaneous carbon dioxide partial pressure in patients undergoing laparoscopic surgery. Arterial carbon dioxide partial pressure is assessed intermittently before, during, and after pneumoperitoneum. End-tidal and transcutaneous carbon dioxide partial pressure are continuously monitored.

Study Timeline

• Status Verified: 2018-04
• Study First Submitted: 2018-04-20
• Study First Submitted QC: 2018-04-24
• Study First Posted: 2018-04-26
• Last Update Submitted: 2018-04-27
• Last Update Posted: 2018-05-01
• Study Start: 2018-05-20
• Primary Completion: 2019-04
• Study Completion: 2019-04

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 142

Inclusion Criteria

• adult patients undergoing laparoscopic surgery (expected duration of pneumoperitoneum > 1 hour) in the Trendelenburg or reverse Trendelenburg positions

Exclusion Criteria

• hemodynamically unstable patients due to decompensated heart failure, sepsis, or symptomatic arrhythmia, etc.
• symptomatic pulmonary disease, chronic obstructive pulmonary disease

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Trendelenburg group	Arterial carbon dioxide monitoring	Arterial, end-tidal, and transcutaneous carbon dioxide partial pressure are monitored in the Trendelenberg position
Trendelenburg group	Transcutaneous carbon dioxide monitoring	Arterial, end-tidal, and transcutaneous carbon dioxide partial pressure are monitored in the Trendelenberg position
reverse Trendelenburg group	Arterial carbon dioxide monitoring	Arterial, end-tidal, and transcutaneous carbon dioxide partial pressure are monitored in the reverse Trendelenberg position
reverse Trendelenburg group	End-tidal carbon dioxide monitoring	Arterial, end-tidal, and transcutaneous carbon dioxide partial pressure are monitored in the reverse Trendelenberg position
reverse Trendelenburg group	Transcutaneous carbon dioxide monitoring	Arterial, end-tidal, and transcutaneous carbon dioxide partial pressure are monitored in the reverse Trendelenberg position
Trendelenburg group	End-tidal carbon dioxide monitoring	Arterial, end-tidal, and transcutaneous carbon dioxide partial pressure are monitored in the Trendelenberg position

Primary Outcome Measures

Name	Time	Method
Difference between arterial and end-tidal carbon dioxide pressures	baseline before CO2 pneumoperitoneum, every 30 minute during CO2 pneumoperitoneum, and 15 min after deflation of CO2	Difference between arterial and end-tidal carbon dioxide partial pressures are calculated. (Arterial carbon dioxide partial pressure minus end-tidal carbon dioxide partial pressure)

Secondary Outcome Measures

Name	Time	Method
Agreement among arterial, end-tidal, and transcutaneous carbon dioxide partial pressure	baseline before CO2 pneumoperitoneum, every 30 minute during CO2 pneumoperitoneum, and 15 min after deflation of CO2	Arterial, end-tidal, and transcutaneous carbon dioxide partial pressures are recorded and the agreement among the values is analyzed using the statistical test.