Periodic Alveolar Recruitment Maneuvers During Elective Spine Surgery Evaluate Effects on Lung Collapse and Breathing Using Ultrasound

What this Trial Is About

Researchers are evaluating whether applying alveolar recruitment maneuvers ARM periodically during elective spine surgery in the prone position can reduce lung collapse atelectasis and improve breathing mechanics under general anesthesia. This randomized controlled trial involves adult patients undergoing spine surgery lasting at least two hours. The study compares a routine single-time ARM with periodic ARM to see if repeated maneuvers better maintain lung aeration and respiratory function during surgery. Participants are randomly assigned to one of two groups. Both receive standard general anesthesia and ventilation, with a baseline ARM after positioning. The periodic ARM group receives additional recruitment maneuvers approximately once per hour during surgery plus a final ARM before extubation. The standard ARM group receives only the baseline and final ARM. All maneuvers are performed within established safety limits without introducing experimental drugs or devices. During the study, lung aeration is assessed using lung ultrasound at multiple time points, including before extubation. Researchers also monitor respiratory mechanics such as airway pressures, lung compliance, oxygen levels, and any transient respiratory or blood flow changes. The main outcome is the incidence of intraoperative atelectasis before extubation. Monitoring continues into the recovery period to evaluate oxygen levels and lung aeration. The total participation duration depends on surgery and immediate recovery phases.

Effects of Periodic Recruitment Maneuvers on Atelectasis and Respiratory Mechanics During Elective Spine Surgery Assessed by Lung Ultrasonography