Comparison Between Two Alveolar Recruitment Maneuvers on Reduction of Lung Atelectasis in Bariatric Surgery by Using Lung Ultrasound Score
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 50
- 试验地点
- 2
- 主要终点
- Improvement of Lung ultrasound score.
研究概览
简要总结
The study aims to compare the staircase alveolar recruitment maneuver with PEEP titration versus sustained inflation alveolar recruitment maneuver by using lung ultrasound score as an indicator of improving lung atelectasis in bariatric surgery
详细描述
Weight loss surgery, often known as bariatric surgery, is an effective obesity treatment. Most people undergoing such surgery may show an improvement in, or the resolution of, conditions such as diabetes, dyslipidemia, hypertension, and obstructive sleep apnea.
Currently, there is no standard ventilation strategy has been established for obese patients. However, there is some evidence that recruitment maneuvers (RM) combined with protective lung ventilation strategy improve oxygenation and compliance compared to other strategies.
Alveolar recruitment maneuver refers to the periodic hyperinflation of the lungs that has been utilized to open up the lung and keep the lung open in anesthetized patients. The use of recruitment maneuvers has been shown to reduce the incidence and extent of atelectasis during general anesthesia by different methods.
Lung ultrasonography is considered a useful tool in perioperative care. Recent research showed that lung ultrasound could assess lung aeration and diagnose anesthesia-induced atelectasis accurately in the perioperative period by measuring the extent of atelectasis by the scoring system; also, the response to recruitment manoeuver for each patient can be evaluated easily. Thus, it has great potential as a bedside non-invasive, sensitive tool for guiding effective recruitment manoeuvers to reduce the formation of pulmonary atelectasis in the surgical setting
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 21 Years 至 65 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult morbidly obese patients (Body mass index < 40kg / m2 or Body mass index < 35kg / m2 with obesity-related comorbidities such as hypertension, diabetes, and sleep apnea)
- •undergo elective bariatric laparoscopic surgery with an expected duration of at least one hour under general anesthesia.
排除标准
- •Patient refusal to participate in the study.
- •Patients with a previous history of thoracic surgery.
- •Patients with a history of chest disease (COPD, emphysema, or pneumothorax).
- •Patients with abnormal pre-operative chest radiographs such as pneumonia, pleural effusion.
- •Patients with heart failure or impending failure.
- •Patients with known hypovolemia.
- •Patients with increased intracranial pressure.
结局指标
主要结局
Improvement of Lung ultrasound score.
时间窗: 48 hours postoperatively
Access lung ultrasound score at the end of surgery
次要结局
- Access Complications of recruitment maneuver(48 hours Postoperatively)
- Access Pulmonary complications(48 hours postoperatively)
- Access incidence of oxygen desaturation(48 hours Postoperatively)
研究者
Alaa Mohsen Shahien
Resident of Anesthesiology, Surgical Intensive Care and Pain Medicine
Tanta University
