THE EFFECT OF ALVEOLAR RECRUITMENT MANOEUVRE ON INTRAOPERATIVE HAEMODYNAMICS
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- Effect of RM on heart rate (in bpm)
研究概览
简要总结
Alveolar recruitment manoeuvre plays a key role in the prevention of atelectasis. In addition, it affects haemodynamic parameters. This study aims to investigate the effects of RM on haemodynamic parameters using minimally invasive monitoring techniques.
详细描述
During laparoscopic hysterectomy, pneumoperitoneum is created with carbon dioxide (CO₂) to provide surgical field of view and the patient is placed in Trendelenburg position. This increases intrathoracic pressure, decreases lung compliance and increases the risk of atelectasis. Therefore, lung protective ventilation strategies such as alveolar recruitment manoeuvre (RM), individualised PEEP application and low tidal volume are recommended. RM aims to increase lung compliance and prevent atelectasis by reopening collapsed alveoli. However, changes in haemodynamic parameters, especially mean arterial pressure and cardiac output, may occur during RM. In addition to standard monitoring for the management of these changes, haemodynamic evaluation can be performed with minimally invasive methods such as arterial waveform analysis. In this study, we aimed to evaluate the effects of RM applied during laparoscopic hysterectomy on intraoperative haemodynamic parameters using arterial waveform analysis.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •ASA Class 1-2 patients 18-70 years old
排除标准
- •<18 y, BMI>40
- •Patients receiving invasive mechanical ventilator support in the last 1 month
- •Patients who have received chemotherapy or radiotherapy in the last 2 months
- •Those with severe lung disease (COPD, asthma, pulmonary infection, bronchiectasis, previous need for non-invasive mechanical ventilation, oxygen therapy or steroid therapy for acute attack)
- •Known severe pulmonary hypertension
- •Patient refusal to participate in the study
- •Intracranial tumour
- •Haemodynamic instability
- •Neuromuscular disease
- •Pathologies causing increased intracranial and intraocular pressure
- •Atrial fibrillation
结局指标
主要结局
Effect of RM on heart rate (in bpm)
时间窗: perioperatively
measurement of heart rate in bpm
Effect of RM on pressure mmHg
时间窗: perioperatively
blood pressure measurement in mmmercury
Effect of RM on Cardiac index(CI)
时间窗: intraoperatively
Cardiac Index measurement via an arterial cannula as l/min/m2
Effect of RM on stroke volume index(SVI)
时间窗: intraoperatively
SVI measurement via arterial cannula as L/min/m2
Effect of RM on pulse pressure variablity(PPV)
时间窗: intraoperatively
pulse pressure variability measured by finger probe as cm/s
Effect of RM on systemic vascular resistance index(SVRI)
时间窗: intraoperatively
systemic vascular resistance index(SVRI) measurement via arterial cannula as L/min/m2
Effect of RM on cardiac power index(CPI)
时间窗: intraoperatively
cardiac power index(CPI) measurement via arterial line as ml/min/m2
次要结局
- Effect of RM on Compliance(intraoperatively)
- Effect of RM on Oxygenation(İntraoperatively)
- Postoperative pulmonary comlications (infection, bronchospasm, pleural effusion, atelectasis, respiratory failure)(postoperative day 1 and 3)
研究者
Ozlem Sagir, MD
Professor, MD
Balikesir University