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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
60
During bypass, patients in this group will receive a lung protective design in the form of continuous positive airway pressure (CPAP) by closing APL valve at pressure of 5 Cm H2o combined with intermittent recruitment by sustained manual lung inflation at a pressure of 35 cmH2O for 30 seconds every (30-40) minute
Cairo University
Cairo, Manil, Egypt
RECRUITINGlung ultrasound score
• 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
Time frame: Baseline,immediately at the end of operation. 2 hours after ICU admission
• The value of Doppler derived E/E' ratio.
Time frame: Baseline,immediately at the end of operation. 2 hours after ICU admission
• Oxygenation (po2),& (po2/fio2)
po2 is measured by mmhg units while PO2/fio2 is ratio
Time frame: Baseline,immediately at the end of operation. 2 hours after ICU admission
• Time for extubation
Time frame: before extubation
Length of ICU stay
Time frame: before discharge to ward up to 1 week
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