Ultrasound Evaluation of Preventive Measures for Postoperative Lung Atelectasis After Surgery

Al-Azhar University60 enrolled

Overview

the aim of this prospective randomized blinded clinical study will be to assess the ultrasound evaluation of different preventive measures of post operative lung atelectasis in abdominal surgeries; these measures include ventilation and fluid measures

ultrasound evaluation for application of different preventive measures of post operative lung atelectasis, including positive end-expiratory pressure, lung recruitment maneuvers, and restrictive fluid management.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Conditions

Pulmonary Atelectasis, Postoperative

Interventions

PEEPOTHER

Patients will be ventilated with PEEP of 8 cm H2O and fluid management: 500 ml of Ringer's lactate in the recovery room before surgery and Ringer's lactate at a rate of 4 mL/kg/hour from the beginning to the end of the surgery.

PEEP/RMOTHER

Patients will be ventilated with PEEP of 8 cm H2O, and then RM (30 cm H2O for 30 s) will be applied immediately after the second LUS examination and repeated every 30 minutes till emergence and fluid management: 500 ml of Ringer's lactate in recovery room before surgery and Ringer's lactate at a rate of 4 mL/kg/hour from the beginning to the end of the surgery

PEEP/RM/RFOTHER

Patients will be ventilated with PEEP of 8 cm H2O, and then RM (30 cm H2O for 30 s) will be applied immediately after the second LUS examination and repeated every 30 minutes till emergence and restrictive fluid management (RF). Ringer's lactate at a rate of 3 mL/kg/hour from the beginning to the end of the surgery

Eligibility

Sex: ALLMin age: 30 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * ASA physical status I or II, of either gender. * BMI \< 40 * Age 30-60 years * scheduled for elective abdominal surgeries Exclusion Criteria: * Patient refusal * American Society of Anesthesiologists (ASA) physical status classification system more than II * BMI \> 40 . * Psychiatric disorders * History of chest disorders such as asthma and obstructive pulmonary disease (COPD). * History of Previous Thoracic Procedures. * Pregnancy

Locations (1)

Al-Azhar university

Asyut, Egypt

Outcomes

Primary Outcomes

Lung ultrasound assessment of postoperative pulmonary atelectasis at the end of surgery

Lung ultrasound assessment of postoperative pulmonary atelectasis at the end of surgery. The Lung Ultrasound Score (LUS): the key points based on ultrasound findings: I. 0 points: (N) Normal aeration (presence of lung sliding with A-lines or \<2 separate B-lines). II. 1 point: (B1) Moderate loss of lung aeration (≥3 well-defined B lines). III. 2 points: (B2) Severe loss of lung aeration (coalescing B-lines). IV. 3 points: (C) Complete loss of lung aeration (pulmonary consolidations). Total Score: points will be distributed according to the worst ultrasound pattern observed: N = 0, B1 lines = 1, B2 lines = 2, C = 3. The LUS score ranging between 0 and 36 was calculated as the sum of points.

Time frame: at the end of surgery before emergence from GA.

Secondary Outcomes

Lung ultrasound assessment

Lung ultrasound assessment of atelectasis

Time frame: before induction of general anesthesia

Lung ultrasound assessment

Lung ultrasound assessment of atelectasis

Time frame: 5 minutes post induction of general anesthesia

Lung ultrasound assessment

Lung ultrasound assessment of atelectasis

Time frame: 15 minutes after patients arrive to PACU

Lung ultrasound assessment

Lung ultrasound assessment of atelectasis

Time frame: 60 minutes after patients arrive to PACU

arterial blood gases

Pao2, spo2, paco2, pao2/fio2

Time frame: 5 minutes post induction of general anesthesia

Data from ClinicalTrials.gov

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