Lung Recruitment Assessment With Lung Ultrasound In Pediatric Patient Scheduled For Laparoscopic Surgery

Not Applicable

Completed

• Conditions: Atelectasis
• Interventions: Other: Lung recruitment maneuver

• Registration Number: NCT02824146
• Lead Sponsor: Hospital Privado de Comunidad de Mar del Plata

Brief Summary

Anesthesia-induced atelectasis is a well-known entity observed in approximately 68-100% of pediatric patients undergoing general anesthesia. The collapse of dependent lung zones starts with anesthesia induction but can persist for hours or even days after surgery. Such anesthesia-related atelectasis has a number of negative clinical consequences such as the impairment of arterial blood oxygenation and lung mechanics as well as the predisposition for ventilator-associated lung injury. The adjustment of ventilator settings for preventing the occurrence of atelectasis and for reducing pulmonary complications remains controversial.

Lung sonography (LUS) plays an important role in diagnosing pulmonary diseases in children, including atelectasis of different origins. LUS has demonstrated its high sensitivity and specificity for diagnosing anesthesia-induced atelectasis in children.

Detailed Description

Compare lung aeration between two different mechanical ventilation strategies (protective mechanical ventilation and recruitment maneuvers) in pediatric patients scheduled for abdominal laparoscopic surgery using ultrasound imaging and a four-point-aeration score to assess the lung aeration.

Study Timeline

• Study Start: 2014-08
• Primary Completion: 2016-05
• Study Completion: 2016-05
• Status Verified: 2016-06
• Study First Submitted: 2016-06-23
• Study First Submitted QC: 2016-07-01
• Last Update Submitted: 2016-07-01
• Study First Posted: 2016-07-06
• Last Update Posted: 2016-07-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 42

Inclusion Criteria

• Written informed consent by parents.
• Patients aged 6 months to 7 years old
• Scheduled for abdominal laparoscopic surgery
• American Society of Anesthesiologists classification: physical status I-II

Exclusion Criteria

• Acute airway infection
• Cardiovascular and or pulmonary disease
• Previous thoracic procedure

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Recruitment maneuver group	Lung recruitment maneuver	Patient received a lung recruitment maneuver after pneumoperitoneum insufflation. The recruitment maneuver consists in 10 breaths at 30/15 cmH2O of plateau pressure and PEEP, respectively. Then, the ventilatory settings back to protective ventilation but adding 8 cmH2O of PEEP to keep the lungs open.

Primary Outcome Measures

Name	Time	Method
Compare lung aeration between protective mechanical ventilation and recruitment maneuvers in pediatric patients scheduled for abdominal laparoscopic surgery using ultrasound imaging and a four point aeration score to assess the lung aeration	intraoperative	Compare lung aeration between protective mechanical ventilation and recruitment maneuvers in pediatric patients scheduled for abdominal laparoscopic surgery using ultrasound imaging and a four point aeration score (0: normal lung aeration, 1: moderate loss of lung aeration, 2: severe loss of lung aeration, 3: complete loss of lung aeration and lung consolidation).

Secondary Outcome Measures

Name	Time	Method
Lung aeration score pre/post the recruitment maneuver during laparoscopic surgery	intraoperative