Effect of Individualized PEEP on Postoperative Pulmonary Complication in Bariatrics

Ain Shams University50 enrolled

Overview

Ventilation with low tidal volume and high PEEP (positive end expiratory pressure) has been shown to improve oxygenation in patients with ARDS (acute respiratory distress syndrome). In obese patients undergoing laparoscopic bariatric surgeries, the risk of postoperative pulmonary complications (PPCs) increases significantly with general anesthesia. Previous studies have shown that protective lung ventilation strategies could improve intraoperative oxygenation and lung mechanics. In this study would compare the effect of optimum individualized high PEEP versus standard PEEP - on postoperative pulmonary complications

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Conditions

Mechanical Ventilation Pressure High Bariatric Surgery Candidate

Interventions

Eligibility

Sex: ALLMin age: 16 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients were eligible for participation if the met the following criteria * Age between 18 and 60 years old. * Body mass index \> 40 * Laparoscopic bariatric elective surgery under general anesthesia. * ARISCAT (Assess Respiratory Risk in Surgical Patients in Catalonia) score ≥ 45 . ARISCAT score is a clinically practical seven-factor scoring system to assess the risk of a composite PPC. Exclusion Criteria: * Previous lung surgery * ASA status III or IV. * Moderate to severe obstructive or restrictive lung disease . * Persistant intraoperative hemodynamic instability . * Need for postoperative mechanical ventilation

Outcomes

Primary Outcomes

postoperative pulmonary complication

pneumonia-atelactasis-bronchospasm-respiratory failure

Time frame: postoperative 10 days after surgery

Secondary Outcomes

Pulmonary functions test

This test includes these values :FVC (forced vital capacity ) FEV1( forced expiratory volume in one sec ) FEV1% and FVC%

Time frame: postoperative 1st , 3rd and 5th day

Central Contacts

wessam selima, MD

CONTACT

+201001958858 w.z.selima@med.asu.edu.eg

ghada sharafeldin, MSc