Role of Individualized Positive End-expiratory Pressure Versus Fixed Positive End-expiratory Pressure in Mechanical Ventilation During Laparoscopic Surgeries
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 75
- Locations
- 1
- Primary Endpoint
- Driving pressure
Study Overview
Brief Summary
To compare the effects of Individualized positive end-expiratory pressure with recruitment maneuver on respiratory parameters and oxygenation in mechanical ventilation during laparoscopic surgeries with the fixed positive end-expiratory pressure and conventional mechanical ventilation without positive end-expiratory pressure.
Detailed Description
Thus study will compare the effects different methods of positive end-expiratory pressure administration in mechanical ventilation on respiratory parameters and oxygenation of the patients undergoing laparoscopic surgeries. There will be three groups of patients which will be as follows: Individualized positive end-expiratory pressure with recruitment maneuver group, fixed positive end-expiratory pressure group and conventional mechanical ventilation. Respiratory parameters; dynamic compliance, driving pressure and ratio of partial pressure of oxygen to fractional inspiration of oxygen will be measured. Mechanical ventilation respiratory parameters i .e. peak pressure, plateu pressure , dynamic compliance and driving pressure will be measured from ventilator machine. P/F ratio( Ratio of partial pressure of oxygen to inspiratory fraction of oxygen) will be measured by taking blood samples for arterial blood gas analysis.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Other
- Masking
- Single (Participant)
Eligibility Criteria
- Ages
- 25 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Age Limit : 25 years to 65 years
- •Patients undergoing laparoscopic suregeries
Exclusion Criteria
- •Hemodynamic instability
- •Bronchospam
- •Patients having COPD
- •History of pulmonary bulla
- •Patients having history of pneumothora
Arms & Interventions
5cm of water Positive End-expiratory Pressure will be applied after induction of general anesthesia
A fixed positive end-expiratory pressure of 5cm of water will administered to the participants after induction of general anesthesia during mechanical ventilation undergoing laparoscopic surgeries.
Intervention: Protective lung ventilation methods with different positive end-expiratory pressure during Laparoscopic Surgeries (Other)
Individualized PEEP with recruitment maneuver guided by driving pressure measurement
Recruitment maneuver will be applied after induction of general anesthesia and indiviualized positive end-expiratory pressure will be applied guided by driving pressue during mechanical ventilation during laparoscopic surgeries.
Intervention: Protective lung ventilation methods with different positive end-expiratory pressure during Laparoscopic Surgeries (Other)
Conventional ventilation
Conventional ventilation method without additional positive end-expiratory pressure will be applied to participants during mechanical ventilation undergoing laparoscopic surgeries.
Outcomes
Primary Outcomes
Driving pressure
Time Frame: 10 minutes after induction of general anesthesia, 10 minutes after pneumoperitonium creation and 10 minutes before extubation of patient
Driving pressure is defined as airway plateau pressure minus positive end-expiratory pressure and reflects the degree of ventilator induced trauma. Airway plateau pressure and positive end-expiratory values will be taken from ventilator monitor.
Dynamic compliance of lungs
Time Frame: 10 minutes after induction of general anesthesia, 10 minutes after pneumoperitonium creation and 10 minutes before extubation of patient
Dynamic compliance is change in lung volume by the change in pressure in the presence of airflow and is calculated by dividing tidal volume of a breath with difference between peak pressure of airway and positive end-expiratory pressure. Tidal volume, peak airway pressure and positive end-expiratory pressure will be noted from ventilator machine monitor.
Oxygenation Index
Time Frame: 10 minutes after induction of general anesthesia and 10 minutes before extubation of patient
Oxygenation index is calculated by following formula: OI = Mean Airway Pressure × FiO2 × 100 ÷ PaO2 FiO2 (fractional inspiration of oxygen) and PaO2 (partial pressure of oxygen) will be recorded from arterial blood gas analysis.
Secondary Outcomes
No secondary outcomes reported
Investigators
Noor-Ul-Ain
Post Graduate Resident Anesthesiology Fellowship of College of Physicians and Surgeons Pakistan
Combined Military Hospital Bahawalpur