Effect of Intraoperative PEEP Individualization According to Driving Pressure in Major Abdominal Surgery
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 100
- 主要终点
- incidence of pulmonary post operative complications
研究概览
简要总结
In this prospective, randomized trial, including patients scheduled for a major open or laparoscopic abdominal surgery (duration >2 hours) under general anesthesia , the investigators will compare 2 strategies of protective mechanical ventilation: a fixed intraoperative PEEP of 6 cmH2O and an individualized intraoperative PEEP according to the driving pressure.
详细描述
Patients will be randomized into 2 groups:
- Fixed PEEP group: will receive protective intraoperative mechanical ventilation: tidal volume: 6 ml/kg of PBW, recruitment maneuvers every immediately after tracheal intubation and every 2 hours and a fixed PEEP of 6 cmH2O
- Individualized PEEP: protective mechanical ventilation with the same modality with an individualization of PEEP levels hourly in order to achieve the lowest driving pressure. PEEP levels will be adjusted after intubation and hourly by increasing or decreasing PEEP levels every 10 respiratory cycles.
The primary outcome: incidence of post operative pulmonary complications during the first post operative days.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Double (Participant, Investigator)
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
- •BMI<35, ARISCAT score > 26, patients scheduled for major abdominal surgery
排除标准
- •unplanned post operative ICU stay and mechanical ventilation
结局指标
主要结局
incidence of pulmonary post operative complications
时间窗: first 7 post operative days
SpO2\< 92%, new chest Xray infiltrates, acute respiratory failure requiring intervention
次要结局
- lung aeration score (LAS)(day 1, day 3 and day 7 after surgery)
研究者
Mhamed Sami Mebazaa
Professor head of anesthesia and intensive care department
Mongi Slim Hospital