Bedside Lung Ultrasound to Assess Lung Recruiting Maneuver With Cardiopulmonary Bypass in Valvular Cardiac Surgery.
试验速览
- 阶段
- 不适用
- 入组人数
- 60
- 试验地点
- 2
- 主要终点
- lung ultrasound score
研究概览
简要总结
The study is designed to use the lung ultrasound to assess the effect of intermittent lung recruitment during cardiopulmonary bypass in cardiac surgeries on extra vascular lung water.
详细描述
Significant respiratory dysfunction is a common problem after cardiac surgery, with an incidence of about 25%. the formation of atelectasis appears to be the primary factor responsible for increased intrapulmonary shunt after cardiac surgery with CPB. The investigators will use the lung ultrasound to evaluate the effects of intermittent recruitment of the lungs during CPB on extra vascular lung water (EVLW).
Objectives :
To evaluate the effect of intermittent lung recruitment during CPB in cardiac surgery on:
Lung ultrasound score (LUS),Oxygenation at different times postoperatively,Time for extubation and length of ICU stay
sixty patients aged from 18-60 years old, scheduled for elective cardiac surgery with CPB will be included in the study. Patients will be randomly allocated into one of two groups: Group A (n=30): will receive intermittent lung recruitment during CPB.Group B (n=30): control group.
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
- Single (Investigator)
盲法说明
numbered, sealed opaque envelope.
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Adult patients aged (18-60 years),
- •elective valvular cardiac surgery with cardiopulmonary bypass (CPB).
排除标准
- •• Emergency surgeries.
- •coronary artery bypass graft surgery
- •patients requiring re-exploration in the immediate postoperative period (within 2hours)
- •left Ventricular ejection fraction less than 40%
- •patients with preoperative congestive heart failure, cardiogenic shock , preoperative pulmonary edema
- •pre-existing severe chronic pulmonary dysfunction (defined as pulmonary disease requiring home oxygen therapy or causing shortness of breath after 1 to 2 flights of stairs)
- •Morbid obesity
- •Renally impaired patients with creatinine more than 2 mg/dl
研究组 & 干预措施
recruitment group
will receive intermittent lung recruitment during CPB
干预措施: lung recruitment (Procedure)
control group
will recieve no intervention
结局指标
主要结局
lung ultrasound score
时间窗: Baseline,immediately at the end of operation. 2 hours after ICU admission
• The change of lung ultrasound score (a score ranging fom 0/36 to 36/36 where 0/36 is best while 36/36 is worst) from the baseline values for assessment of extra vascular lung water after CBP
次要结局
- • The value of Doppler derived E/E' ratio.(Baseline,immediately at the end of operation. 2 hours after ICU admission)
- • Oxygenation (po2),& (po2/fio2)(Baseline,immediately at the end of operation. 2 hours after ICU admission)
- • Time for extubation(before extubation)
- Length of ICU stay(before discharge to ward up to 1 week)
研究者
Maged Abdel-Wahab Abdel-Aziz
assistant lecturer
Cairo University