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Post-neurosurgical Respiratory Muscle Dysfunction

Recruiting
Conditions
Pulmonary Complication
Diaphragm Issues
Neurosurgery
Interventions
Diagnostic Test: Maximum inspiratory/Expiratory manoeuvre for patients can follow the order
Registration Number
NCT05951114
Lead Sponsor
Beijing Sanbo Brain Hospital
Brief Summary

Respiratory muscle dysfunction may contribute to the development of postoperative pulmonary complications. However, it prevalence in patients receiving neurosurgery is largely unknown. Therefore, in present study, respiratory muscle function (measured by the ultrasound) and their correlation with the post-operative pulmonary complications will be analyzed.

Detailed Description

Postoperative pulmonary complications is common in patients receiving neurosurgery, and is associated with hospitalization cost and mortality. Respiratory muscle dysfunction is an important cause postoperative pulmonary complications, however, it's prevalence in patients receiving neurosurgery is unclear.

The diaphragm and abdominal expiratory muscles are the main inspiratory and expiratory driving muscles. Ultrasound can assess the function and morphology of these muscles invasively and in realtime. Studies has demonstrated their feasibility and repeatability in realtime monitoring of respiratory muscles.

In this study, our primary aim is to assess the respiratory muscle function after neurosurgery, and the correlation between diaphragm and expiratory muscle function. Our secondary aims including the correlation between the brain injury and the respiratory muscle function, and the impact of post-operative respiratory muscle dysfunction on the pulmonary complications.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Informed consent
  • First elective operation during hospitalization
  • ASA<3
Exclusion Criteria
  • Brain stem and spinal spine lesions
  • Preoperative chest imaging findings were abnormal
  • Mechanical ventilation was required before surgery
  • Clinical or radiological evidence of preoperative misaspiration
  • History of neurosurgery in the last 6 months
  • A history of neuromuscular disease
  • BMI≥35kg/m2
  • Pregnant women
  • Skin lesions detected by ultrasound

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Patients with diaphragm weaknessMaximum inspiratory/Expiratory manoeuvre for patients can follow the orderDiaphragm weakness will be defined as thickening fraction \<=20 % at the time of extubation
Patients without diaphragm weaknessMaximum inspiratory/Expiratory manoeuvre for patients can follow the orderDiaphragm thickening fraction \>20 % at the time of extubation
Primary Outcome Measures
NameTimeMethod
Incidence of diaphragm dysfunction after neurosurgeryWithin 24 hours after the completion of surgery

The diaphragm dysfunction is defined as the thickening fraction \< 20% under the maximum inspiration

Secondary Outcome Measures
NameTimeMethod
The correlation between the level of inflammation maker ILs and the diaphragm functionWithin 24 hours after the completion of surgery

The level of ILs are measured in the blood sample within 24 hours after surgery

The thickening fraction of expiratory muscles after surgeryWithin 24 hours after the completion of surgery

the thickening fraction of expiratory muscle is measured under the maximum expiration maneuver

The length of ICU stayThrough study completion, an average of 1 month

The length of ICU stay is counted by day

The correlation between the level of NSE and the diaphragm functionWithin 24 hours after the completion of surgery

The level of NSE is measured in the blood sample within 24 hours after surgery

The incidence of postoperative pulmonary complicationThrough study completion, an average of 1 month

The postoperative pulmonary complication is defined as when patient has developed one or more complications including pneumonia, atelectasis, pulmonary edema, pulmonary embolism, or respiratory failure

Hospital mortalityThrough study completion, an average of 1 month

The hospital mortality is recorded at the time of discharge

The length of hospital stayThrough study completion, an average of 1 month

The length of hospital stay is counted by day

Duration of mechanical ventilationThrough study completion, an average of 1 month

The duration of mechanical ventilation is counted by hours

The correlation between the level of inflammation maker TNF-alpha and the diaphragm functionWithin 24 hours after the completion of surgery

The level of TNF-alpha is measured in the blood sample within 24 hours after surgery

Trial Locations

Locations (1)

Beijing Sanbo Brain Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

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