Respiratory muscle dysfunction may contribute to the development of postoperative pulmonary complications. However, it prevalence in patients receiving neurosurgery is largely unknown. Therefore, in present study, respiratory muscle function (measured by the ultrasound) and their correlation with the post-operative pulmonary complications will be analyzed.
Postoperative pulmonary complications is common in patients receiving neurosurgery, and is associated with hospitalization cost and mortality. Respiratory muscle dysfunction is an important cause postoperative pulmonary complications, however, it's prevalence in patients receiving neurosurgery is unclear. The diaphragm and abdominal expiratory muscles are the main inspiratory and expiratory driving muscles. Ultrasound can assess the function and morphology of these muscles invasively and in realtime. Studies has demonstrated their feasibility and repeatability in realtime monitoring of respiratory muscles. In this study, our primary aim is to assess the respiratory muscle function after neurosurgery, and the correlation between diaphragm and expiratory muscle function. Our secondary aims including the correlation between the brain injury and the respiratory muscle function, and the impact of post-operative respiratory muscle dysfunction on the pulmonary complications.
Study Type
OBSERVATIONAL
Enrollment
100
Bedside ultrasound will be performed for each patient at the time before, after surgery, before and after extubation, and at the time of ICU discharge, under the end-expiratory occlusion, maximum inspiratory, and/or expiratory manoeuvre
Beijing Sanbo Brain Hospital, Capital Medical University
Beijing, Beijing Municipality, China
RECRUITINGIncidence of diaphragm dysfunction after neurosurgery
The diaphragm dysfunction is defined as the thickening fraction \< 20% under the maximum inspiration
Time frame: Within 24 hours after the completion of surgery
The correlation between the level of NSE and the diaphragm function
The level of NSE is measured in the blood sample within 24 hours after surgery
Time frame: Within 24 hours after the completion of surgery
The correlation between the level of inflammation maker ILs and the diaphragm function
The level of ILs are measured in the blood sample within 24 hours after surgery
Time frame: Within 24 hours after the completion of surgery
The correlation between the level of inflammation maker TNF-alpha and the diaphragm function
The level of TNF-alpha is measured in the blood sample within 24 hours after surgery
Time frame: Within 24 hours after the completion of surgery
The thickening fraction of expiratory muscles after surgery
the thickening fraction of expiratory muscle is measured under the maximum expiration maneuver
Time frame: Within 24 hours after the completion of surgery
The incidence of postoperative pulmonary complication
The postoperative pulmonary complication is defined as when patient has developed one or more complications including pneumonia, atelectasis, pulmonary edema, pulmonary embolism, or respiratory failure
Time frame: Through study completion, an average of 1 month
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The length of hospital stay
The length of hospital stay is counted by day
Time frame: Through study completion, an average of 1 month
The length of ICU stay
The length of ICU stay is counted by day
Time frame: Through study completion, an average of 1 month
Duration of mechanical ventilation
The duration of mechanical ventilation is counted by hours
Time frame: Through study completion, an average of 1 month
Hospital mortality
The hospital mortality is recorded at the time of discharge
Time frame: Through study completion, an average of 1 month