Lung Recruitment Improves Right Ventricle Performance

Not Applicable

Completed

• Conditions: Atelectasis
• Interventions: Procedure: Lung recruitment maneuver

• Registration Number: NCT02795208
• Lead Sponsor: Hospital Privado de Cordoba, Argentina

Brief Summary

This study test whether a lung recruitment maneuver improves the right ventricle performance after cardiopulmonary bypass. Half of the patients received an standard protective ventilation and the other half the same ventilatory pattern after a lung recruitment maneuver.

Detailed Description

Atelectasis is developed in 90% of anesthetized patients after surgery.

Protective ventilation with low tidal volumes and positive-end expiratory pressure (PEEP) promotes atelectasis with the potential right ventricle dysfunction induced by the increment in afterload (activation of the pulmonary hypoxic vasocontriction reflex).

Lung recruitment can improve the right ventricle performance caused by atelectasis because the pulmonary hypoxic vasocontriction reflex desapear in a normal aerated lungs.

Study Timeline

• Study Start: 2015-03
• Primary Completion: 2016-03
• Study Completion: 2016-04
• Status Verified: 2016-06
• Study First Submitted: 2016-06-05
• Study First Submitted QC: 2016-06-08
• Study First Posted: 2016-06-10
• Last Update Submitted: 2016-06-12
• Last Update Posted: 2016-06-14

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

• cardiovascular surgery with cardiopulmonary bypass.
• Patients with a New York Heart Association (NYHA) class I-II,
• Pre-operative left ventricular ejection fraction ≥ 50 %.
• Euroscore ≤ 6.

Exclusion Criteria

• TEE contraindications.
• Hemodynamically unstable
• Needi for inotropic support

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Recruitment maneuver group	Lung recruitment maneuver	Patient received a lung recruitment maneuver after cardiopulmonary bypass. The recruitment maneuver consists in 10 breaths at 40/20 cmH2O of plateau pressure and PEEP, respectively. Then, the .ventilatory settings back to protective ventilation but adding 10 cmH2O of PEEP to keep the lungs open.

Primary Outcome Measures

Name	Time	Method
Right ventricle assessment by transesophageal echocardiography	intraoperative

Secondary Outcome Measures

Name	Time	Method
PaO2 and respiratory compliance	intraoperative
Atelectasis assessment by transesophageal echocardiography	intraoperative