Ultrasound Guided Recruitment Manauvere Versus Individualized Positive End Expiratory Pressure in Pediatric Patients Undergoing Laparoscopic Abdominal Surgery
- Conditions
- Pediatric PatientsUltrasound Guided Recruitment ManauvereLaparoscopic Abdominal SurgeryEnd Expiratory Pressure
- Interventions
- Other: Fixed PEEPOther: Ultrasound-guided lung recruitmentOther: Individualized PEEP
- Registration Number
- NCT06306820
- Lead Sponsor
- Tanta University
- Brief Summary
The aim of this prospective randomized controlled study is to compare the effect of US-guided Recruitment Manauvere (RM) versus individualized positive end-expiratory pressure (PEEP) on oxygenation and preventing respiratory complications in pediatric patients undergoing laparoscopic abdominal surgeries.
- Detailed Description
Atelectasis is among the most frequent postoperative pulmonary complications (PPCs) of general anesthesia with an incidence of between 68% and 100% in children. Atelectasis impairs gas exchange, thus causing hypoxemia and other respiratory disorders such as acute lung injury and pneumonia.
Pneumoperitoneum is another risk factor for perioperative atelectasis. It elevates the diaphragm and intra-abdominal pressure. In order to prevent atelectasis, applying positive end-expiratory pressure (PEEP) or an alveolar recruitment Maneuvere (RM) have shown beneficial effects.
Lung ultrasound (US) is a noninvasive, radiation-free, convenient, and reproducible bedside imaging modality for anesthesia-induced atelectasis in children.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 120
- Age from 3 to 8 years.
- Both sexes.
- American Society of Anesthesiologists (ASA) physical status I-II.
- Children scheduled for elective laparoscopic abdominal surgeries.
- Parental refusal.
- Bronchial asthma or any preexisting chest disease.
- Congenital deformity of the thoracic cage.
- Patients with a history of thoracic surgery.
- Cardiac, hepatic, or renal failure.
- Obese children with BMI at or above 95th percentile of the same age and sex.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Control group Fixed PEEP Patients will receive a fixed positive end-expiratory pressure (PEEP) of 5 cmH2O. Ultrasound group Ultrasound-guided lung recruitment Patients will receive ultrasound -guided lung recruitment. PEEP IND group Individualized PEEP Patients will receive individualized positive end-expiratory pressure (PEEP).
- Primary Outcome Measures
Name Time Method Intraoperative oxygenation One hour after second recruitment Maneuvere Intraoperative oxygenation which will be assessed by P/F ratio (the ratio of arterial oxygen partial pressure (PaO2 in mmHg) to fractional inspired oxygen P/F ratio will be assessed before induction of anesthesia, one hour after pneumoperitoneum, and after second recruitment Maneuvere (RM)
- Secondary Outcome Measures
Name Time Method Mean arterial blood pressure (MAP) One hour after extubation Mean arterial blood pressure (MAP) will be assessed before induction of anesthesia, immediately after intubation, after first recruitment Maneuvere (RM), one hour after pneumoperitoneum, after second recruitment Maneuvere (RM), and one hour after extubation.
Lung ultrasound scores 24 hours after extubation Lung ultrasound scores to assess anesthesia-induced atelectasis and will be performed immediately after intubation, one hour after pneumoperitoneum, one hour after extubation, and 24 hours after extubation
Heart rate One hour after extubation Heart rate (HR) will be assessed before induction of anesthesia, immediately after intubation, after first recruitment Maneuvere (RM), one hour after pneumoperitoneum, after second recruitment Maneuvere (RM), and one hour after extubation.
Postoperative pulmonary complication 24 hours postoperative Early postoperative pulmonary complication in the first 24 hours postoperative.
Trial Locations
- Locations (1)
Tanta University
🇪🇬Tanta, El-Gharbia, Egypt