Comparison of Intraabdominal Pressure

Not Applicable

• Conditions: Prone Position
• Interventions: Device: Chest roll; Device: Wilson frame; Device: Jackson surgical table

• Registration Number: NCT02094976
• Lead Sponsor: Seoul National University Hospital

Brief Summary

Increased intra-abdominal pressure(IAP) might influence on perioperative morbidity related to increased CVP, PVWP, SVR, PAP and decreased venous return and cardiac output. Prone position has been known to increase IAP. In clinical field, various apparatuses has developed to minimize IAP elevation during prone position operation.

In this study, we would compare the changes of IAP and respiratory system compliance according to positional apparatus in prone position.

Detailed Description

In clinical field, Wison frame, chest rolls and Jackson table have been widely used for prone position surgery. Among those apparatus, Jackson table has padded supports under the chest and pelvis, so that the abdomen can hang freely and prevent the abdominal compression. By reducing abdominal and thoracic pressure, Jackson table would reduce blood loss, and less effects on pulmonary mechanics. But few studies has known to compare IAP with other positioning apparatus such as Wilson frame or chest roll.

Study Timeline

• Study Start: 2013-09
• Status Verified: 2014-03
• Study First Submitted: 2014-03-20
• Study First Submitted QC: 2014-03-20
• Last Update Submitted: 2014-03-20
• Study First Posted: 2014-03-24
• Last Update Posted: 2014-03-24
• Primary Completion: 2014-09

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 138

Inclusion Criteria

• Patients who are scheduled for prone positioned spinal surgery
• ASA Physical Status Classification System class I or II

Read More

Exclusion Criteria

• Patients who did not agree
• BMI > 30kg/m2
• Patients who did not insert urinary foley catheter
• Patients who have COPD or emphysema
• Patients who have severe spine deformities such as scoliosis

Read More

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Group C	Chest roll	Group C means active comparator group which use chest rolls intraoperatively for prone position.
Group W	Wilson frame	Group W means experimental group which use Wilson frame intraoperatively for prone position.
Group J	Jackson surgical table	Group J means experimental group which use Jackson surgical table intraoperatively for prone position.

Primary Outcome Measures

Name	Time	Method
changes of Intraabdominal presure (IAP)	5 minute after position change	Compare IAP changes from supine to prone according to the positional apparatus : Wilson frame, Chestrolls and Jackson table

Secondary Outcome Measures

Name	Time	Method
Changes of IAP and total respiratory system comliance (Crs) accoridng to PEEP change	1min after PEEP change	Compare IAP and Crs according to PEEP changes in each group. PEEP applied 0,3,6 and 9 cm H2O and recoding was done at 1min after PEEP change.; Total respiratory system compliance (Crs) = TV/(Pplat-PEEP)
changes of dead space ventilation after position change	5 minute after prone position	After genearal anesthetic induction, arterial blood gas analyssis (ABGA)was done at supine position. And then the position was changed to prone. 5minutes after prone position change, ABGA repeated, and calculated the dead space ventilation at each point.; Dead space ventilation (Vd/Vt) = \[PaCo2-PETCO2\]/PaCo2; Finally, we would compare changes of dead space ventilation after position change.
Hemodynamic change	1min after PEEP change	Check the hemodynamic changes according to PEEP change : 0,3,6 and 9 cmH2O

Trial Locations

Locations (1)

Seoul National University of Hospital; 🇰🇷 Seoul, Korea, Republic of