Background: There is a lack of studies regarding Optimal (best) positive end-expiratory pressure (PEEP) in prone position during surgery, and its relation with optimal PEEP in supine position. Hypothesis: In patients undergoing scheduled spinal surgery, optimal PEEP in the prone position is lower than optimal PEEP in the supine position. Aims: To assess the difference optimal PEEP in supine vs. prone positions in patients undergoing spine surgery. To evaluate the changes in optimal PEEP in prone position throughout the surgical procedure. Methods: Observational study, one center. Main variable: optimal PEEP. Secondary variables: PaO2, pCO2 and dynamic compliance (Crd) in prone and supine position.
Recruitment: Patients scheduled for spine surgery were Main outcome: Optimal PEEP determined after a pulmonary recruitment manoeuvre in supine and in prone position and every hour during the surgery in prone position. Secondary outcomes: Pulmonary compliance, blood gas analysis and hemodynamic parameters
Study Type
OBSERVATIONAL
Enrollment
20
Assessment of optimal Positive End-Expiratory Pressure (PEEP) in patients undergoing scheduled spine surgery in prone position.
Hospital del Mar
Barcelona, Spain
Positive End-Expiratory Pressure (PEEP)
Positive End-Expiratory Pressure (cmH2O) in supine position
Time frame: 10 minutes after intubation
Positive End-Expiratory Pressure (PEEP)
Positive End-Expiratory Pressure (cmH2O) in prone position
Time frame: 10 minutes after positioning
Change in Positive End-Expiratory Pressure (PEEP)
Variation of Positive End-Expiratory Pressure (cmH2O) during surgery in prone position with respect to PEEP value at 10 minutes after positioning
Time frame: From determination of optimal PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours)
Static compliance
Tidal volume / Plateau pressure ratio (mL/cmH2O) in supine position
Time frame: 10 minutes after intubation
Static compliance
Tidal volume / Plateau pressure ratio (mL/cmH2O) in prone position
Time frame: 10 minutes after positioning
Change in static compliance
Variation of static compliance (Tidal volume / Plateau pressure ratio, in mL/cmH2O) during surgery in prone position
Time frame: Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours)
Arterial oxygen pressure (PaO2)
Partial pressure of oxygen (mmHg) in supine position
Time frame: 10 minutes after intubation
Arterial oxygen pressure (PaO2)
Partial pressure of oxygen (mmHg) in prone position
Time frame: 10 minutes after positioning
Change in arterial oxygen pressure (PaO2)
Variation of partial pressure of oxygen (mmHg) during surgery in prone position
Time frame: Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours)
Arterial carbon dioxide pressure (PaCO2)
Partial pressure of carbon dioxide (mmHg) in supine position
Time frame: 10 minutes after intubation
Arterial carbon dioxide pressure (PaCO2)
Partial pressure of carbon dioxide (mmHg) in prone position
Time frame: 10 minutes after positioning
Change in arterial carbon dioxide pressure (PaCO2)
Variation of partial pressure of carbon dioxide (mmHg) during surgery in prone position
Time frame: Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours)
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