Inhomogeneous Ventilation in Adult Post-neurosurgical Patients: an Observational Study
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- Incidence of inhomogeneous ventilation
研究概览
简要总结
Inhomogeneous ventilation was more likely to happen in patients after general anesthesia. Inhomogeneous ventilation may associate with ventilator-induced lung injury. A large number of post-neurosurgical patients was delayed extubation and received mechanical ventilation, so that, inhomogeneous ventilation was more likely to happen in the population. Electrical impedance tomography (EIT) is an noninvasive, radiation-free, high temporal resolution, relatively cheap technique in monitoring ventilation distribution bedside. The investigators aimed to investigate the incidence of inhomogeneous ventilation and factors associated with inhomogeneous ventilation in post-neurosurgical patients under mechanical ventilation.
详细描述
Inhomogeneous ventilation was more likely to happen in patients after general anesthesia. Inhomogeneous ventilation may associate with ventilator-induced lung injury since the gravity-depend collapse and over-distention of nondependent regional in patients under mechanical ventilation. A large number of post-neurosurgical patients was delayed extubation and received mechanical ventilation, so that, inhomogeneous ventilation was more likely to happen in the population. Up to now, there is no research reported about the prevalence of inhomogeneous ventilation and the factors associated with inhomogeneous ventilation in post-neurosurgical patients, in present study, The investigators prospectively enrolled adult patients after neurosurgical operations. Electrical impedance tomography (EIT) is an noninvasive, radiation-free, high temporal resolution, relatively cheap technique in monitoring ventilation distribution bedside. The investigators aimed to investigate the incidence of inhomogeneous ventilation and factors associated with inhomogeneous ventilation in post-neurosurgical patients under mechanical ventilation.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Other
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Undergoing elective neurosurgery operation
- •Trachea intubated and mechanical ventilated
排除标准
- •Age under 18 years-old
- •Unstable hemodynamics patients (mean arterial pressure under 65mmHg) after pharmacotherapy
- •History of chronic obstructive pulmonary disease(COPD) or asthma
- •Contraindication of using EIT (pacemaker, defibrillator, and implantable pumps)
- •Unable to install EIT belt (skin infection, wound)
- •Incompleteness of thorax (e.g. pneumothorax, rib fracture and etc.) or malformation of thorax.
结局指标
主要结局
Incidence of inhomogeneous ventilation
时间窗: within 24 hours after neurosurgical operative
In supine position, global image of EIT was divided into upper and lower part, each part accounting for 50%, which was named as non-dependent region and dependent region respectively. Inhomogeneous ventilation was defined as the ratio between tidal impedance variation of dependent region(VTdep) and global tidal impedance variation (VT) is less than 45% during stable Spontaneous breath, which was defined as variation of tidal volume less than 10% in continuous 6 breathes.
次要结局
- The incidence of postoperative pulmonary complications(PPCs)(28 days after neurosurgical operative)
- Length of ICU stay(through study completion, an average of 7 days)
- Length of hospital stay(through study completion, an average of 28 days)
研究者
Jian-Xin Zhou
Professor
Capital Medical University