Effects of recruitment maneuver and positive end-expiratory pressure on respiratory mechanics and transpulmonary pressure during laparoscopic surgery.
Gilda Cinnella, Salvatore Grasso, Savino Spadaro...
https://pubmed.ncbi.nlm.nih.gov/23196259Actively Recruiting
Phase Not Applicable
Age: 18Years +
All Genders
ID06850844
Impact of Recruitment Maneuvers and PEEP-guided Electrical Impedance Tomography on Regional Ventilation, Gas Exchange, and Pulmonary Mechanics in in Abdominal Laparoscopic Surgery Patients
Led by Nguyen Dang Thu · Updated on 2025-02-27
70
Participants Needed
1
Research Sites
2 weeks
Total Duration
On this page
Sponsors
N
Nguyen Dang Thu
Lead Sponsor
B
Bach Mai Hospital
Collaborating Sponsor
AI-Summary
What this Trial Is About
Abdominal laparoscopy is widely utilized due to its benefits, including minimal invasiveness, improved cosmetic outcomes, and shorter hospital stays. However, the use of intraoperative pneumoperitoneum and general anesthesia with mechanical ventilation may lead to postoperative pulmonary complications, such as atelectasis. This condition can result in diminished respiratory mechanics and impaired gas exchange. In recent years, intraoperative lung-protective mechanical ventilation techniques, including recruitment maneuvers (RMs) and positive end-expiratory pressure (PEEP) strategies, have gained popularity. These approaches aim to prevent the repeated collapse and reopening of alveoli, thereby reducing the risk of atelectasis. Nonetheless, determining the optimal PEEP level for individual patients remains a complicated and unresolved issue. Electrical impedance tomography (EIT) is a bedside imaging technique that assesses regional ventilation distribution, providing a method for personalizing PEEP settings in mechanically ventilated patients. By addressing the competing risks of alveolar overdistension and collapse, EIT enhances the precision of PEEP titration. This study aims to compare the effects of recruitment maneuvers and EIT-guided PEEP selection against conventional ventilation on regional ventilation, gas exchange, and pulmonary mechanics in patients undergoing abdominal laparoscopic surgery.
CONDITIONS
Brief Title
Recruitment Maneuvers and PEEP-guided Electrical Impedance Tomography for Abdominal Laparoscopic Surgery Patients
Who Can Participate
Age: 18Years +
All Genders
Eligibility Criteria
You may qualify if you...
- Age > 18 years
- Scheduled for abdominal laparoscopy surgery
- At increased (i.e., intermediate or high) risk of postoperative pulmonary complications according to the "Assess Respiratory Risk in Surgical Patients in Catalonia" (ARISCAT) score (≥ 26 points)
- Signed written informed consent
You will not qualify if you...
- Major previous lung surgery (e.g., lung resection)
- Severe chronic obstructive pulmonary disease and/or severe emphysema
- Increased intracranial pressure
- Contraindications for EIT (pacemakers, automatic external defibrillators, cases of chest trauma or recent chest surgery limiting EIT belt application)
- Presence of pneumothorax that is either undrained or newly occurred.
- Unstable hemodynamics with a mean arterial pressure < 60 mmHg and unresponsive to resuscitation measures, and/or heart rate < 60 bpm.
- Pregnancy.
- Severe neuromuscular disease.
AI-Screening
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1
2
3
Trial Site Locations
Total: 1 location
1
Anesthesia Center, Bach Mai Hospital
Hanoi, Vietnam, 10000
Actively Recruiting
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Research Team
T
Thanh Huyen Thi Pham, M.D
How is the study designed?
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
Effect of PEEP on regional ventilation during laparoscopic surgery monitored by electrical impedance tomography.
J Karsten, H Luepschen, M Grossherr...
https://pubmed.ncbi.nlm.nih.gov/21658014Individualized positive end-expiratory pressure in obese patients during general anaesthesia: a randomized controlled clinical trial using electrical impedance tomography.
C Nestler, P Simon, D Petroff...
https://pubmed.ncbi.nlm.nih.gov/29045567Positive end-expiratory pressure optimization using electric impedance tomography in morbidly obese patients during laparoscopic gastric bypass surgery.
K Erlandsson, H Odenstedt, S Lundin...
https://pubmed.ncbi.nlm.nih.gov/16879466