Lung Atelectasis Improvement Through Positive End Expiratory Pressure During Anesthetic Induction

Not Applicable

Not yet recruiting

• Conditions: Lung Injury, Acute

• Registration Number: NCT06900426
• Lead Sponsor: Fudan University

Brief Summary

Anesthetic induction could lead to lung atelectasis, increase intrapulmonary shunt, and potentially impair oxygenation. The study aimed to validate that a positive end-expiratory pressure (PEEP) of 10 cmH2O could reduce lung atelectasis, comparing to 0 or 5 cmH2O with limited overdistension.

Detailed Description

General anesthesia may introduce lung atelectasis, which causes an increase in intrapulmonary shunt, and impairs oxygenation, even in the lung-healthy subjects. The magnitude of shunt is correlated with the formation of pulmonary atelectasis. The study aimed to validate that a positive end-expiratory pressure (PEEP) of 10 cmH2O could reduce lung atelectasis, comparing to 0 or 5 cmH2O with limited overdistension. Surgical patients with healthy lungs were randomly assigned to receive 0, 5 or 10 cmH2O PEEP (PEEP0, PEEP5 and PEEP10 groups). Anesthetic induction was performed by certified registered anesthesiologists, during which the patients were mechanically ventilated using the volume-controlled mode. Electrical impedance tomography (EIT) was used to dynamically assess the lung atelectasis during anesthetic induction (spontaneous, mask, and endotracheal intubation ventilation). The primary outcome was the dorsal change of end expiratory lung impedance (△EELI) after 2 mins anesthetic induction. The secondary outcome was driving pressure, EIT-derived ventilation homogeneity, hemodynamics and PaO2/FiO2.

Study Timeline

• Status Verified: 2025-03
• Study First Submitted: 2025-03-17
• Study First Submitted QC: 2025-03-22
• Last Update Submitted: 2025-03-22
• Study Start: 2025-03-28
• Study First Posted: 2025-03-28
• Last Update Posted: 2025-03-28
• Primary Completion: 2025-04-28
• Study Completion: 2025-04-28

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

• between 18 and 80 years
• scheduled for elective non-cardiothoracic cancer surgery
• general anesthesia.

Exclusion Criteria

• acute or chronic respiratory disorders, such as chronic obstructive pulmonary disease (COPD) or asthma;
• a history of lung surgery
• a high risk of reflux and aspiration
• a requirement for awake intubation
• facial or thoracic deformities
• the presence of implants, such as cardiac pacemakers
• pregnant

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
the dorsal △EELV after 2 minutes anesthetic induction	2 minutes after anesthetic induction	The primary outcome was the dorsal △EELV after 2 minutes anesthetic induction (endotracheal intubation ventilation) monitored by EIT.

Secondary Outcome Measures

Name	Time	Method
driving pressure	2 minutes after anesthetic induction	Pplat - PEEP
GI	2 minutes after anesthetic induction	Global imhomogeneity monitored by EIT
CoV	2 minutes after anesthetic induction	The central of ventilation monitored by EIT
hemodynamics	During anesthetic induction	Blood pressure
PaO2/FiO2	During anesthetic induction	PaO2/FiO2 during anesthetic induction

Trial Locations

Locations (1)

Fudan University Shanghai Cancer Centre; 🇨🇳 Shanghai, Shanghai, China