Ultrasound Evaluation of Different Preventive Measures of Post Operative Lung Atelectasis After Upper Abdominal Surgeries: Ventilation and Fluid Measures
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Lung ultrasound assessment of postoperative pulmonary atelectasis at the end of surgery
研究概览
简要总结
the aim of this prospective randomized blinded clinical study will be to assess the ultrasound evaluation of different preventive measures of post operative lung atelectasis in abdominal surgeries; these measures include ventilation and fluid measures
详细描述
ultrasound evaluation for application of different preventive measures of post operative lung atelectasis, including positive end-expiratory pressure, lung recruitment maneuvers, and restrictive fluid management.
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, Care Provider)
入排标准
- 年龄范围
- 30 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •ASA physical status I or II, of either gender.
- •BMI < 40
- •Age 30-60 years
- •scheduled for elective abdominal surgeries
排除标准
- •Patient refusal
- •American Society of Anesthesiologists (ASA) physical status classification system more than II
- •BMI > 40 .
- •Psychiatric disorders
- •History of chest disorders such as asthma and obstructive pulmonary disease (COPD).
- •History of Previous Thoracic Procedures.
- •Pregnancy
研究组 & 干预措施
Group I: PEEP
Patients will be ventilated with PEEP of 8 cm H2O and fluid management: 500 ml of Ringer's lactate in the recovery room before surgery and Ringer's lactate at a rate of 4 mL/kg/hour from the beginning to the end of the surgery.
干预措施: PEEP (Other)
Group II: PEEP/RM
Patients will be ventilated with PEEP of 8 cm H2O, and then RM (30 cm H2O for 30 s) will be applied immediately after the second LUS examination and repeated every 30 minutes till emergence and fluid management: 500 ml of Ringer's lactate in recovery room before surgery and Ringer's lactate at a rate of 4 mL/kg/hour from the beginning to the end of the surgery
干预措施: PEEP/RM (Other)
Group III: PEEP/RM/RF
Patients will be ventilated with PEEP of 8 cm H2O, and then RM (30 cm H2O for 30 s) will be applied immediately after the second LUS examination and repeated every 30 minutes till emergence and restrictive fluid management (RF). Ringer's lactate at a rate of 3 mL/kg/hour from the beginning to the end of the surgery
干预措施: PEEP/RM/RF (Other)
结局指标
主要结局
Lung ultrasound assessment of postoperative pulmonary atelectasis at the end of surgery
时间窗: at the end of surgery before emergence from GA.
Lung ultrasound assessment of postoperative pulmonary atelectasis at the end of surgery. The Lung Ultrasound Score (LUS): the key points based on ultrasound findings: I. 0 points: (N) Normal aeration (presence of lung sliding with A-lines or \<2 separate B-lines). II. 1 point: (B1) Moderate loss of lung aeration (≥3 well-defined B lines). III. 2 points: (B2) Severe loss of lung aeration (coalescing B-lines). IV. 3 points: (C) Complete loss of lung aeration (pulmonary consolidations). Total Score: points will be distributed according to the worst ultrasound pattern observed: N = 0, B1 lines = 1, B2 lines = 2, C = 3. The LUS score ranging between 0 and 36 was calculated as the sum of points.
次要结局
- Lung ultrasound assessment(60 minutes after patients arrive to PACU)
- arterial blood gases(15 minutes after patients arrive to PACU)
- Lung ultrasound assessment(before induction of general anesthesia)
- Lung ultrasound assessment(5 minutes post induction of general anesthesia)
- Lung ultrasound assessment(15 minutes after patients arrive to PACU)
- arterial blood gases(5 minutes post induction of general anesthesia)
- arterial blood gases(before emergence from general anesthesia)
研究者
Hamed Mohamed Wally Allah
Assistant lecturer in Anesthesia, Intensive Care and pain management department, Faculty of Medicine, Al-Azhar University (Assiut)
Al-Azhar University