Evaluation of Protective Pulmonary Ventilation by Pulmonary Ultrasound
Study Details
Study Description
Brief Summary
Peri - operative ultrasonography was used to evaluate the effects of protective lung ventilation on the postoperative lungs of obese patients.The purpose of this study was to apply ultrasound lung ventilation area score to the monitoring of pulmonary complications in patients with postoperative obesity.To verify the reliability and practicability of perioperative lung ultrasound quantitative scoring.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
Ultrasound lung ventilation area score was applied to monitor the pulmonary complications of patients after obesity operation to verify the perioperative period.
The reliability and practicability of quantitative lung ultrasound score to clarify the effect of protective lung ventilation under perioperative pulmonary ultrasound monitoring on obesity patients.To guide the management of mechanical ventilation under general anesthesia and the prevention and treatment of postoperative pulmonary complications
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| PEEP The patient was admitted to the operating room, and routine ECG monitoring was performed. The patient was placed in supine position, and ultrasound lung examination was performed. The images of the patient were saved and the score of lung ventilation area was recorded. The induction of general anesthesia was started, and endotracheal intubation was performed after 3min of preoxygenation (100% O2) to establish a safe and effective artificial airway.Mechanical ventilation was performed after endotracheal intubation, and a second time was performed immediately after endotracheal intubation was completed.Pulmonary ultrasound was performed. The PEEPgroup was given the first RM (pulmonary retraction) with pressure maintained at 40cmH2O for 30s, followed by a 7cmH2O PEEP to maintain mechanical ventilation, and the RMS was repeated every 30 minutes until the end of surgery |
Behavioral: recruitment maneuvers
Immediately after endotracheal intubation is completed
First RM (pulmonary retraction), maintain pressure at 40cmH2O for 30s, and then
Mechanical ventilation was maintained with 7cmH2O PEEP, and the RMS was repeated every 30 minutes until the end of surgery
|
| ZEEP The patient was admitted to the operating room, and routine ECG monitoring was performed. The patient was placed in supine position, and ultrasound lung examination was performed. The images of the patient were saved and the score of lung ventilation area was recorded. The induction of general anesthesia was started, and endotracheal intubation was performed after 3min of preoxygenation (100% O2) to establish a safe and effective artificial airway. Mechanical ventilation was performed after endotracheal intubation, and a second time was performed immediately after endotracheal intubation was completed On pulmonary ultrasound, patients in the ZEEP group maintained normal mechanical ventilation throughout the operation without PEEP or RMS |
Behavioral: recruitment maneuvers
Immediately after endotracheal intubation is completed
First RM (pulmonary retraction), maintain pressure at 40cmH2O for 30s, and then
Mechanical ventilation was maintained with 7cmH2O PEEP, and the RMS was repeated every 30 minutes until the end of surgery
|
Outcome Measures
Primary Outcome Measures
- Lung ultrasound scoring [in the morning of the first day]
Four signs were used in lung ultrasound scoring Lung ultrasound score: N (0): pleural line and A line, less than 3 B lines; B1 (1 mark): More than 3 B line; B2 (2 points): Fuse line B; C (3 points): Signs of lung consolidation. The higher the score is, the worse the pulmonary ventilation status is. When scoring, the sign with the greatest severity is taken as the score value of the examination area. There are 12 examination areas in both lungs, so we have a LUS The score is between 0 and 36
Secondary Outcome Measures
- Results of arterial blood gas analysis [entering the operating room, in the morning of the first day ,the second day , the third day after surgery]
PCO2
- Mechanical ventilation parameter [entering the operating room, in the morning of the first day ,the second day , the third day after surgery]
peak inspiratory pressure
Eligibility Criteria
Criteria
Inclusion Criteria:
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enrollment of patients aged 18 years or above；
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Eligible adult patients had an American Society of Anesthesiologists (ASA) physical status classification of I to IV
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undergoing elective or expedited nonurgent, noncardiac surgery with general anesthesia
Exclusion Criteria:
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patient refusal;
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morbid obesity (BMI >40 kg/ m²);
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American Society of Anesthesiologists (ASA) physical status categories IV-V;
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previous intrathoracic procedure;
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severechronic obstructive pulmonary disease (forced expiratory volume in 1 s <30% of the predicted value;
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a contraindication to radial artery cannulation.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | General Hospital of Ningxia Medical University | Yinchuan | Ningxia | China | 750004 |
Sponsors and Collaborators
- General Hospital of Ningxia Medical University
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Costamagna A, Pivetta E, Goffi A, Steinberg I, Arina P, Mazzeo AT, Del Sorbo L, Veglia S, Davini O, Brazzi L, Ranieri VM, Fanelli V. Clinical performance of lung ultrasound in predicting ARDS morphology. Ann Intensive Care. 2021 Mar 29;11(1):51. doi: 10.1186/s13613-021-00837-1.
- Wangüemert Pérez AL. Clinical applications of pulmonary ultrasound. Med Clin (Barc). 2020 Apr 10;154(7):260-268. doi: 10.1016/j.medcli.2019.11.001. Epub 2020 Jan 8. Review. English, Spanish.
- KYLL-2021-277