Effect of optimum positive end expritaory presssure on post-operative lung atelectasis in children

Recruiting

• Conditions: Malignant neoplasm of bone and articular cartilage of limbs,

• Registration Number: CTRI/2021/04/033104
• Lead Sponsor: Deaprtment of anaesthesiology pain medicine and critical care

Brief Summary

General anaesthesia used during surgery predisposes patients to postoperative pulmonary compliacations which includes pneumonia, atelectasis, respiratory failure etc which increases the morbidity and mortality of patients postoperatively. Children are more susceptible because of their anatomical and physiological differences such as the decreased FRC due to the increased compliance of their chest wall which provided reduced counterbalance to the inward elastic recoil of the lugs. Application of lung recruitment manoeuver, appropriate PEEP thus becomes necessary to keep the alveoli open and maintain adequate oxygenation during the course of surgery. We hypothesize that an optimum PEEP based on best lung compliance  can improve intraoperative oxygenation and thus reduce postoperative lung atelectasis as assessed by lung ultrasound score

Detailed Description

Not available

Study Timeline

• Study Start: 2021-01-05
• Last Update Posted: 2022-05-31

Recruitment & Eligibility

• Status: Open to Recruitment
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

Elective major orthopaedic surgery in supine position.

Exclusion Criteria

• 1.Parental refusal to participate in the study.
• 2.Children with known severe lung disease.
• 3.Children with a history of severe lung infection having post infection sequelae in preoperative chest x-ray.
• 4.Children with known deformity of chest wall or thoracic spine.
• 5.Children undergoing spine surgery in prone or lateral position.
• 6.Children with pre-existing significant cardiac, renal or hepatic diseases.
• Children with history of previous thoracic surgery.
• 8.Children with BMI > 30 kg/m2.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To find the incidence of significant atelectasis defined as consolidation score 2 in any region in post operative lung ultrasound assessment.	lung ultrasound images will be obtained at 4 predefined time points: | T-1 Before induction of general anaesthesia | T-2 Five minutes after intubation before lung recruitment | T-3 Before extubation | T-4 One hour after extubation in PACU (Post Anaesthesia Care Unit)

Secondary Outcome Measures

Name	Time	Method
Correlation of lung ultrasound score with	PaO2 / FiO2 ratio

Trial Locations

Locations (1)

All India Institute of Medical Sciences; 🇮🇳 South, DELHI, India

All India Institute of Medical Sciences

🇮🇳South, DELHI, India

Teyongtangla Imsong

Principal investigator

9582503138

teyongtangla@gmail.com