Regional ventilation distribution in adult patients undergoing neurosurgical procedures in different positions - a prospective interventional study using electrical impedance tomography.
试验速览
- 阶段
- 2/3 期
- 状态
- 尚未招募
- 入组人数
- 45
- 试验地点
- 1
- 主要终点
- • To determine the changes in EIT parameters - global inhomogeneity index (GII), Anterior/Posterior ratio (A/P ratio), and Respiratory ventilation delay (RVD) in adult neurosurgical patients undergoing surgery in supine, lateral and prone positions.
研究概览
简要总结
Protecting the lungs during surgery is important because mechanical ventilation can sometimes cause lung injury, Newer approaches focus on adjusting ventilation to suit individual patients. Electrical impedance tomography is a safe, noninvasive method that allows real time monitoring of how air is distributed in different parts of the lungs without radiation.
Neurosurgical patients are especially vulnerable to changes in lung function during surgery due to long operating times, mechanical ventilation, fluid shifts and interactions between the brain and lungs. Neurosurgical procedures require patients to be placed in different positions such as supine, lateral or prone, which can significantly affect breathing and oxygen levels.
Previous studies show that body position influences how evenly air is distributed in the lungs. Prone positioning often improves ventilation in the posterior parts of the lungs and reduces lung collapse, but it may overstretch other lung areas. The effects of lateral positioning vary between patients. There is limited information on these position related changes specifically in neurosurgical patients.
There is also uncertainty about the best ventilation mode and pressure settings during neurosurgery. While moderate positive end pressure can improve lung expansion and reduce collapse, higher pressures may affect brain blood flow and pressure inside the skull. Studies using electrical impedance tomography suggest that moderate pressure improves ventilation distribution, but optimal settings differ between patients and positions.
This study aims to monitor and compare changes in lung ventilation in adult neurosurgical patients operated in different body positions using electrical impedance tomography. The findings may help guide personalised ventilation strategies and reduce the risk of lung injury during surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 盲法
- None
入排标准
- 年龄范围
- 18.00 Year(s) 至 65.00 Year(s)（—）
- 性别
- All
入选标准
- •PATIENTS UNDERGOING ELECTIVE NEUROSURGERY UNDER GENERAL ANAESTHESIA.
排除标准
- •Refusal of consent
- •Patients with an endotracheal tube in situ prior to the planned surgical procedure
- •Pregnancy
- •Patients with cardiac failure, cardiac pacemakers, etc.
- •Obese patients (BMI more than 30)
- •At risk of aspiration – poor GCS, bulbar palsy
- •Patients with known respiratory disease – pleural effusion, pneumothorax, COPD, Asthma, pneumonia, emphysematous bulla.
结局指标
主要结局
• To determine the changes in EIT parameters - global inhomogeneity index (GII), Anterior/Posterior ratio (A/P ratio), and Respiratory ventilation delay (RVD) in adult neurosurgical patients undergoing surgery in supine, lateral and prone positions.
时间窗: At basline, after induction, after positioning, every 5 minutes for 1 hour.
• To compare the EIT parameters - global inhomogeneity index (GII), Anterior/Posterior ratio (A/P ratio), and Respiratory ventilation delay (RVD) changes with volume and pressure-controlled ventilation.
时间窗: At basline, after induction, after positioning, every 5 minutes for 1 hour.
次要结局
- • To compare the EIT parameters - global inhomogeneity index (GII), Anterior/Posterior ratio (A/P ratio), and Respiratory ventilation delay (RVD) changes with PEEP zero and 5 cmH2O in both ventilation modes.(• To correlate the EIT paramters - global inhomogeneity index (GII), Anterior/Posterior ratio (A/P ratio), and Respiratory ventilation delay (RVD) changes with changes in driving pressure and lung compliance.)
研究者
Soumi Sunabh Parulkar
National Institute of Mental Health And Neuro Sciences