Postoperative Atelectasis in Pediatric Patients With Prone Position

Not Applicable

Completed

• Conditions: Atelectasis, Compression; Pulmonary Atelectasis, Postoperative
• Interventions: Procedure: One recruitment with PEEP; Procedure: Repetitive recruitment with PEEP

• Registration Number: NCT03486847
• Lead Sponsor: Seoul National University Hospital

Brief Summary

This study evaluates the incidence of postoperative atelectasis after general anesthesia with prone position using lung ultrasound in children age \< 3 years.

Detailed Description

Atelectasis is common in pediatric patients after general anesthesia. Particularly, infants are more likely to develop atelectasis or ventilation-perfusion imbalance after general anesthesia because of the immature ribs and respiratory muscles, the high compliance of the rib cage and a significant reduction in functional residual capacity (FRC) during general anesthesia. Previous studies have reported that alveolar recruitment and positive end-expiratory pressure (PEEP) can be used to reduce atelectasis in children. Also, previous studies have shown that the lung ultrasound can be used to evaluate the degree of atelectasis during general anesthesia in children.

However, none of the previous studies investigated the incidence of atelectasis, the effect of alveolar recruitment, and the PEEP in pediatric patients under general anesthesia with prone position. The purpose of this study was to evaluate previously described parameters using lung ultrasound.

Study Timeline

• Study First Submitted: 2018-03-26
• Study Start: 2018-03-29
• Study First Submitted QC: 2018-04-01
• Study First Posted: 2018-04-03
• Primary Completion: 2019-07-31
• Study Completion: 2019-07-31
• Status Verified: 2020-04
• Last Update Submitted: 2020-04-15
• Last Update Posted: 2020-04-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 74

Inclusion Criteria

• Children undergoing general anesthesia with prone position
• Endotracheal intubation and mechanical ventilation during general anesthesia
• Operation time is more than 2 hours

Exclusion Criteria

• Previous lung surgery
• Any abnormal findings such as atelectasis, pneumothorax, pleural effusion, or pneumonia on preoperative chest X-ray
• Researchers judge (to be inappropriate)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
One recruitment with PEEP	One recruitment with PEEP	One alveolar recruitment at before surgery
Repetitive recruitment with PEEP	Repetitive recruitment with PEEP	One alveolar recruitment at before surgery and repetitive alveolar recruitment (once an hour) during surgery

Primary Outcome Measures

Name	Time	Method
Incidence of pre-extubation atelectasis	postoperative 10 minutes	Incidence of pre-extubation atelectasis accessed by lung ultrasound

Secondary Outcome Measures

Name	Time	Method
Incidence of intraoperative hypotension	intraoperative	Systolic blood pressure (SBP) ≤ 20% below the baseline value
Incidence of intraoperative and postoperative (within 12hr) desaturation	intraoperative and postoperative (within 12hr)	Oxygen saturation by pulse oximetry (SpO2) ≤ 95% or 10% below the baseline value
Incidence of intraoperative atelectasis after intubation	intraoperative	Incidence of intraoperative atelectasis after induction accessed by lung ultrasound
Incidence of intraoperative atelectasis after position change to prone	intraoperative	Incidence of intraoperative atelectasis after position change to prone accessed by lung ultrasound

Trial Locations

Locations (1)

SNUH; 🇰🇷 Seoul, Jongnogu, Korea, Republic of