Ignite Creation Date:
2024-07-17 @ 10:47 AM
Last Modification Date:
2024-10-26 @ 3:34 PM
Study NCT ID:
NCT06494410
Status:
COMPLETED
Last Update Posted:
2024-07-15
First Post:
2024-07-02
Brief Title:
Effect of High Versus Low Fraction of Inspired Oxygen During Alveolar Recruitment
Sponsor:
Egymedicalpedia
Organization:
Egymedicalpedia
Study Overview
Official Title:
Comparison of the Effect of High Versus Low Fraction of Inspired Oxygen During Alveolar Recruitment on Absorption Atelectasis in Laparoscopic Bariatric Surgery Patients With Atelectasis
Status:
COMPLETED
Status Verified Date:
2023-02
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Intraoperative absorption atelectasis is associated with decreased lung compliance impaired oxygenation increased pulmonary vascular resistance and lung injury
The alveolar recruitment maneuver RM with positive-end expiratory pressure PEEP has been advocated as efficient for absorption atelectasis treatment
During general anesthesia absorption atelectasis reportedly occurs in most patients especially during laparoscopic surgery the increased abdominal pressure of capnoperitoneum may shift the diaphragm cranially and decrease respiratory compliance
The alveolar recruitment maneuver RM with positive-end expiratory pressure PEEP has been advocated as efficient for absorption atelectasis treatment
During general anesthesia absorption atelectasis reportedly occurs in most patients especially during laparoscopic surgery the increased abdominal pressure of capnoperitoneum may shift the diaphragm cranially and decrease respiratory compliance
Detailed Description:
The incidence of obesity defined by a body mass index BMI 30 kgm2 is increasing worldwide In selected individuals bariatric surgery may offer means of achieving long-term weight loss improved health and healthcare cost reduction Physiological changes that occur because of obesity and general anesthesia predispose to respiratory complications following bariatric surgery
Obesity affects many respiratory functions including among others a reduction in functional residual capacity an increase in airway resistance and a high level of ventilation-perfusion mismatch The combination of obesity and postoperative respiratory muscle dysfunction could promote respiratory failure
Absorption atelectasis occurs in most patients typically due to absorption of gas compression of the lung tissue and impairment of surfactant function Additionally during laparoscopic surgery the increased abdominal pressure of capnoperitoneum may shift the diaphragm cranially and decrease respiratory compliance
Compression of basal lung regions due to a stiffened diaphragm would accelerate the formation of absorption atelectasis that was already initiated during anesthesia induction
Such deterioration is associated with pulmonary densities revealed by computed tomography In addition to physiologic impairment atelectasis could contribute to perioperative lung injury and PPC
The RM with PEEP has been advocated as efficient for atelectasis treatment Reports on the impact of FiO2 during RM on atelectasis development are rare and have not limited FiO2 to the RM per se
While RM with high FiO2 can improve oxygenation rapidly there is a greater possibility of absorption atelectasis occurring
Diagnostic ultrasonography is the only clinical imaging technology in use that does not depend on electromagnetic radiation Lung ultrasonography can be considered an attractive complementary diagnostic tool and one of the most promising techniques Daabis et al 2014 Therefore Lung ultrasonography is a safe and cheap tool used during the perioperative period and to detect intraoperative respiratory complications resulting from absorption atelectasis
The modified Lung Ultrasound Score LUSS system involves examination of all intercostal spaces each hemi-thorax is divided into six regions 2 anterior 2 lateral and 2 posterior with four longitudinal lines and one axial line figure 1 B C Each region score shows sufficient sensitivity to detect loss of aeration during laparoscopic surgery The degree of de-aeration rated from 0 to 3 zero for no atelectasis and 3 for complete atelectasis defining substantial atelectasis as a score of 2 or 3 assigned to any region
Obesity affects many respiratory functions including among others a reduction in functional residual capacity an increase in airway resistance and a high level of ventilation-perfusion mismatch The combination of obesity and postoperative respiratory muscle dysfunction could promote respiratory failure
Absorption atelectasis occurs in most patients typically due to absorption of gas compression of the lung tissue and impairment of surfactant function Additionally during laparoscopic surgery the increased abdominal pressure of capnoperitoneum may shift the diaphragm cranially and decrease respiratory compliance
Compression of basal lung regions due to a stiffened diaphragm would accelerate the formation of absorption atelectasis that was already initiated during anesthesia induction
Such deterioration is associated with pulmonary densities revealed by computed tomography In addition to physiologic impairment atelectasis could contribute to perioperative lung injury and PPC
The RM with PEEP has been advocated as efficient for atelectasis treatment Reports on the impact of FiO2 during RM on atelectasis development are rare and have not limited FiO2 to the RM per se
While RM with high FiO2 can improve oxygenation rapidly there is a greater possibility of absorption atelectasis occurring
Diagnostic ultrasonography is the only clinical imaging technology in use that does not depend on electromagnetic radiation Lung ultrasonography can be considered an attractive complementary diagnostic tool and one of the most promising techniques Daabis et al 2014 Therefore Lung ultrasonography is a safe and cheap tool used during the perioperative period and to detect intraoperative respiratory complications resulting from absorption atelectasis
The modified Lung Ultrasound Score LUSS system involves examination of all intercostal spaces each hemi-thorax is divided into six regions 2 anterior 2 lateral and 2 posterior with four longitudinal lines and one axial line figure 1 B C Each region score shows sufficient sensitivity to detect loss of aeration during laparoscopic surgery The degree of de-aeration rated from 0 to 3 zero for no atelectasis and 3 for complete atelectasis defining substantial atelectasis as a score of 2 or 3 assigned to any region
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None