Evaluation of the Effects of Different Ventilation Modes Used During Anesthesia Awakening on the Frequency of Postoperative Atelectasis by Lung Ultrasonography: A Prospective Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 278
- 主要终点
- Modified Transthoracic Ultrasound Score
研究概览
简要总结
In our study, we aimed to detect atelectasis developing in patients undergoing surgery under general anesthesia using transthoracic lung ultrasonography and to investigate the effect of ventilation methods used during recovery from anesthesia on the formation of postoperative atelectasis.
详细描述
Postoperative atelectasis is one of the most common pulmonary complications seen in surgical patients. Postoperative pulmonary complications and possible respiratory side effects have long been associated with anesthesia. Pulmonary complications are an important cause of morbidity and mortality in the postoperative period. The incidence of postoperative pulmonary complications due to long-term anesthesia varies between 5% and 80%, depending on the patient population, the surgery performed, and the criteria used to define the complication. It is known that the recovery period makes a significant contribution to the total amount of postoperative atelectasis. Spontaneously breathing patients are under the influence of anesthetic agents and neuromuscular blockers and cannot regain their functional residual capacity. For this reason, it is emphasized that atelectasis may develop in the postoperative period in cases whose anesthesia application is terminated by applying a spontaneous breathing period. Pressure support ventilation (PSV) is widely used for ventilator weaning in the intensive care unit (ICU) and has recently been available on anesthesia machines.
It is expected that the use of lung ultrasonography in operating rooms can reduce the complications that may develop in the postoperative period with evidence-based detection and early postoperative detection of atelectasis in the early postoperative period.
In this study, it was aimed to compare the effect of pre-extubation ventilation mode applied by anesthesia practitioners with ultrasound in the postoperative period on the frequency of atelectasis in adult patients who underwent surgery and whose lungs were evaluated as normal by ultrasound in the preoperative observation room. Modified LUS scores were used as lung ultrasonography evaluation criteria in the study.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Patients undergoing general anesthesia with supine position
- •Endotracheal intubations and mechanical ventilation during general anesthesia
- •Operation time is more than 2 hours
排除标准
- •Patients who will undergo surgical intervention under emergency conditions
- •Pregnancy
- •Upper respiratory tract disease in the last 3 weeks
- •Previous lung surgery
- •Advanced cardiac and/or pleural lung disease and chest wall deformity, and primary or metastatic lung cancer
结局指标
主要结局
Modified Transthoracic Ultrasound Score
时间窗: two weeks
Both lungs were determined as anterior and posterior axillary lines as anatomical markers and divided into a total of 12 regions, 4 in the anterior thoracic wall, 4 in the lateral wall, and 4 in the posterior region. While the anterior and lateral regions were examined in the supine position by placing the probe perpendicular to the thoracic wall and longitudinal in the intercostal spaces with the bat sign displayed, especially the posterior regions close to the diaphragm were examined by placing the probe transversely in the intercostal spaces by turning the patient opposite. According to the systematic LUS protocol, each patient was evaluated for approximately 10-15 minutes and optimum images were obtained.Each area was scored on a scale of 0-3 according to the degree of atelectasis, and a total score between 0 (normal lung ventilation image) and 36 (total loss of ventilation) was calculated.
次要结局
未报告次要终点
研究者
Busra Otlu
Assistant professor
Dokuz Eylul University