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临床试验/CTRI/2022/10/046764
CTRI/2022/10/046764已完成不适用

A comparative study of driving pressure guidedindividualized versus fixed positive end expiratory pressureon incidence of postoperative lung atelectasis in patientsundergoing laparoscopic surgeries in trendelenburg position: A double blinded random

AIIMS1 个研究点 分布在 1 个国家目标入组 82 人开始时间: 2022年8月11日最近更新:

试验速览

阶段
不适用
状态
已完成
发起方
AIIMS
入组人数
82
试验地点
1
主要终点
To identify whether an individualized PEEP guided by driving pressures can reduce the magnitude of postoperative ( 30 minutes after extubation) lung atelectasis as compared to a fixed PEEP assessed by change in modified lung ultrasound score

研究概览

简要总结

  • The study will be done on patients undergoing laparoscopic urological or gynecological surgeries in trendelenberg position.
  • 82 randomized patients will be recruited of which 41 patients will be assigned to  study group and 41 patients will be assigned to control group.
  • The participants in the test group shall receive driving pressure guided individualized PEEP and the control group participants shall receive fixed PEEP throughout the surgery.
  • Driving pressures would be calculated by using the formula (Pplat - PEEP) and the PEEP at which lowest possible driving pressures are observed is fixed throughout the surgery.
  • Lung recruitment  will be done in both the study groups. Incremental PEEP protocol shall be used in test group.
  • The principal investigator is blinded to the study groups and the intervention will be done by an experienced anesthesiologist in the operation theater.
  • After the patient is shifted to the post anesthetic care unit lung ultrasound will be done by the principal investigator to look for any B lines and lung consolidation and Lung Ultrasound Sore (LUS) will be determined based on USG findings.
  • Other parameters like intra operative arterial blood gas analysis, ventilatory parameters, vitals, details of the surgery will be recorded in the case record form.
  • On completion both the groups will be studied and analyzed independently and various parameters mentioned above will be compared.

研究设计

研究类型
Interventional
分配方式
Computer generated randomization
盲法
Participant and Investigator Blinded

入排标准

年龄范围
18.00 Year(s) 至 65.00 Year(s)(—)
性别
All

入选标准

  • Patients undergoing laparoscopic urological and gynaecological surgeries.
  • ASA PS 1 & 2 patients.

排除标准

  • Patients refusal to participate in the study 2) Previous thoracic surgeries or massive blood loss >40ml/Kg 3) Patients with ARDS / lung injury / COPD / chronic lung disease.
  • Recent history of upper respiratory tract infection/ history of bronchial asthma 5) Significant cardiac, renal or hepatic disease.
  • BMI <18 or >30 Kg/m2.

结局指标

主要结局

To identify whether an individualized PEEP guided by driving pressures can reduce the magnitude of postoperative ( 30 minutes after extubation) lung atelectasis as compared to a fixed PEEP assessed by change in modified lung ultrasound score

时间窗: 24 hours after extubation of the patient

次要结局

  • Post operative oxygen requirement(Post operative period)

研究者

发起方
AIIMS
申办方类型
Government medical college

研究点 (1)

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