Peroperative Use of Positive End-expiratory Pressure Prevents Formation of Atelectasis as Studied by Computerised Tomography at End of Surgery
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Region Västmanland
- Enrollment
- 24
- Locations
- 1
- Primary Endpoint
- Measurement of aeras with different aeration in the particular CT scan.
Study Overview
Brief Summary
Atelectasis is common during and after general anaesthesia and a number of interventions have been suggested in order to prevent their formation. The use of Positive End Expiratory Pressure (PEEP) during general anaesthesia has in recent years been questioned.
The investigators hypothesize that the use of PEEP as a single intervention improves oxygenation and prevents atelectasis as investigated by computed tomography compared to a control group with zero PEEP.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Ages
- 40 Years to 75 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Healthy subjects, American Society of Anesthesiology (ASA) I-II.
- •Patients scheduled for non-abdominal day case surgery under general anaesthesia.
Exclusion Criteria
- •ASA class III or higher.
- •Body Mass Index (BMI) 30 or higher.
- •Arterial oxygen saturation (SpO2) <96% breathing air.
- •Chronic Obstructive Pulmonary Disease (COPD).
- •Ischaemic heart disease.
- •Known or anticipated difficult airway.
- •Active smokers and ex-smokers with a history of more than 6 pack years.
- •Need for interscalene or supraclavicular plexus block for postoperative pain relief (risk of phrenic nerve paralysis).
Arms & Interventions
PEEP group
Induction and maintenance of anaesthesia in a conventional manner. Peroperative ventilatory settings using positive end-expiratory pressure.
Intervention: Positive end-expiratory pressure (Procedure)
Control group zero PEEP
Induction and maintenance of anaesthesia in a conventional manner. Peroperative ventilatory settings using zero end-expiratory pressure.
Intervention: Control group, zero PEEP (Procedure)
Outcomes
Primary Outcomes
Measurement of aeras with different aeration in the particular CT scan.
Time Frame: Within 1-2 hours, just before emergence from anesthesia.The outcome measure (atelectasis) will be investigated at just one point i.e. end of surgery but before emergence from anaesthesia.
The areas of different aeration are assessed by computed tomography (CT) 5-10 mm above the dome of the right diaphragm and expressed in centimeter\^2 and as a percentage of the total lung area in the particular scan.
Area of atelectasis expressed as centimeter^2
Time Frame: Within 1-2 hours, just before emergence from anesthesia.The outcome measure (atelectasis) will be investigated at just one point i.e. end of surgery but before emergence from anaesthesia.
The area of atelectasis in the lungs is assessed by computed tomography (CT) 5-10 mm above the dome of the right diaphragm and expressed in centimeter\^2 and as a percentage of the total lung area in the particular scan.
Secondary Outcomes
- Oxygenation, oxygen tension in arterial blood expressed in kilo Pascal (kPa)(Within 2 hours perioperatively, 15 minutes after extubation.)
- Oxygenation, oxygen tension in arterial blood expressed in kilo Pascal (kPa)(Within 1-2 hours, just before emergence from anesthesia. At end of surgery but before emergence from anaesthesia, at the same time as the lungs are investigated by computed tomography.)
Investigators
Erland Ostberg
M.D.
Region Västmanland