Optimal Positive End-expiratory Pressure (PEEP) in Prone Position During Spine Surgery. A Prospective Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Change in Positive End-Expiratory Pressure (PEEP)
研究概览
简要总结
Background:
There is a lack of studies regarding Optimal (best) positive end-expiratory pressure (PEEP) in prone position during surgery, and its relation with optimal PEEP in supine position.
Hypothesis:
In patients undergoing scheduled spinal surgery, optimal PEEP in the prone position is lower than optimal PEEP in the supine position.
Aims:
To assess the difference optimal PEEP in supine vs. prone positions in patients undergoing spine surgery.
To evaluate the changes in optimal PEEP in prone position throughout the surgical procedure.
Methods:
Observational study, one center. Main variable: optimal PEEP. Secondary variables: PaO2, pCO2 and dynamic compliance (Crd) in prone and supine position.
详细描述
Recruitment: Patients scheduled for spine surgery were Main outcome: Optimal PEEP determined after a pulmonary recruitment manoeuvre in supine and in prone position and every hour during the surgery in prone position.
Secondary outcomes: Pulmonary compliance, blood gas analysis and hemodynamic parameters
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥18 years.
- •Spine prone surgery lasting ≥2 hours.
- •Absence of known pulmonary pathology.
排除标准
- •Pregnancy or lactation.
- •Contraindication to alveolar recruitment maneuvers (risk of barotrauma, hemodynamic instability).
- •Body mass index (BMI) >
- •Heart failure defined as IC <2.5 L/min/m2 and/or inotropic support requirements prior to surgery.
- •Diagnosis or suspicion of intracranial hypertension (intracranial pressure >15 mmHg).
结局指标
主要结局
Change in Positive End-Expiratory Pressure (PEEP)
时间窗: From determination of optimal PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours)
Variation of Positive End-Expiratory Pressure (cmH2O) during surgery in prone position with respect to PEEP value at 10 minutes after positioning
Positive End-Expiratory Pressure (PEEP)
时间窗: 10 minutes after positioning
Positive End-Expiratory Pressure (cmH2O) in prone position
次要结局
- Arterial oxygen pressure (PaO2)(10 minutes after positioning)
- Change in static compliance(Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours))
- Arterial carbon dioxide pressure (PaCO2)(10 minutes after positioning)
- Change in arterial carbon dioxide pressure (PaCO2)(Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours))
- Static compliance(10 minutes after positioning)
- Change in arterial oxygen pressure (PaO2)(Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours))