Open Lung Approach Versus Conventional Protective Ventilation in Obese Patients Undergoing Open Abdominal Surgery: A Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Abdominal Surgery
- Sponsor
- Zagazig University
- Enrollment
- 48
- Locations
- 1
- Primary Endpoint
- post-operative pulmonary complications
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
the purpose of this study is to compare open lung approach versus conventional protective ventilation in obese patients undergoing open abdominal surgery
Detailed Description
after being informed about the study and potential risks. All patients giving written consent will be randomized by double blind manner into 2 groups each one containing 24 patients Group SPV: will be ventilated using volume controlled ventilation (7ml/kg tidal volume) with addition of 5 cm H₂O fixed PEEP till the end of the surgery . Group OLA: The patients will undergo ARM followed by personalized PEEP.
Investigators
Marwa Mohamed Medhat
lecture of anesthesia and surgical intensive care (Principal Investigator)
Zagazig University
Eligibility Criteria
Inclusion Criteria
- •Patient aged between 18 - 65 years
- •BMI between 30-40 kg/m²
- •ASA I and II,open elective abdominal surgery which is expected to last for more than 2 hours under general anesthesia and planned to be extubated at the end of surgery
Exclusion Criteria
- •Emergency surgery, pregnancy, chronic obstructive pulmonary disease (FEV1 \< 80% of the predicted value)
- •active asthma, acute respiratory distress syndrome
- •history of pneumothorax, lung cyst, Difficult airway, obstructive sleep apnea,ischemic heart disease, heart failure
- •significant arrhythmias and intracranial hypertension. Exposure to radiotherapy and chemotherapy within 2 months before surgery. Advanced Cardiovascular ,liver, renal diseases ischemic heart disease, heart failure, significant arrhythmias and intracranial hypertension
Outcomes
Primary Outcomes
post-operative pulmonary complications
Time Frame: one week postoperative
Pulmonary function tests will be done before surgery as a baseline then repeated after the surgery when the patient is fully awake using bedside spirometer in the sitting position.
Secondary Outcomes
- heart rate(Baseline (before surgery) and intraoperative)
- length of hospital stay,(postoperative up to one month)
- pulmonary complications.(one week postoperative)
- mean arterial blood pressure(Baseline (before surgery) and intraoperative)
- airway pressure(intraoperative)
- tidal volume(intraoperative)
- SpO2(Baseline (before surgery) and intraoperative)
- ETCO2(Baseline (before surgery) and intraoperative)