Pulmonary Complications in Elderly Patients

China-Japan Friendship Hospital136 enrolled

Overview

The incidence of postoperative pulmonary complications in elderly patients undergoing upper abdominal laparoscopic surgery remains high, and the lung protective mechanical ventilation strategy aims to reduce the incidence of lung injury caused by ventilators. PEEP, as an important protective ventilation strategy, maintains end expiratory alveolar volume to improve intraoperative oxygenation and pulmonary respiratory mechanics, and plays a protective role in the lungs; Personalized PEEP is the most beneficial, especially for elderly patients. However, there is currently no ideal way to achieve precise and personalized regulation of PEEP. This project aims to target and control intraoperative mechanical ventilation to drive pressure, personalize PEEP titration, and conduct a randomized controlled study on perioperative changes in pulmonary oxygenation function and pulmonary complications in elderly patients undergoing upper abdominal laparoscopy.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

136

Conditions

Postoperative Complications

Interventions

Eligibility

Sex: ALLMin age: 60 YearsMax age: 80 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * ASA\<III、 general anesthesia, 60-80 years, BMI\<30kg/m2, pneumoperitoneum time\>0.5h, laparoscopic surgery on the upper abdomen (stomach, liver, gallbladder) Exclusion Criteria: * Severe anemia (Hb\<60g/L), OSA, severe COPD (FEV1\<30% pre), asthma, bronchiectasis, preoperative pulmonary infection, respiratory failure, thoracic deformity, postoperative return to ICU, heart function grade III-IV, severe liver and kidney dysfunction (Child B or C, dialysis), intraoperative bleeding greater than 30% of blood volume.

Outcomes

Primary Outcomes

the changes of oxygenation index

The patients' changes of Oxygenation index when leave-PACU, one-day after surgery and 7-day after surgery compared with pre-sugery oxygenation index

Time frame: pre-surgery, leave-PACU, one-day after surgery and 7-day after surgery

Secondary Outcomes

Incidence of pulmonary complications

Incidence of pulmonary complications at 30 and 90 days after surgery

Time frame: 30 and 90 days after surgery