THE EFFECT OF ALVEOLAR RECRUITMENT MANOEUVRE ON INTRAOPERATIVE HAEMODYNAMICS

Balikesir University70 enrolled

Overview

Alveolar recruitment manoeuvre plays a key role in the prevention of atelectasis. In addition, it affects haemodynamic parameters. This study aims to investigate the effects of RM on haemodynamic parameters using minimally invasive monitoring techniques.

During laparoscopic hysterectomy, pneumoperitoneum is created with carbon dioxide (CO₂) to provide surgical field of view and the patient is placed in Trendelenburg position. This increases intrathoracic pressure, decreases lung compliance and increases the risk of atelectasis. Therefore, lung protective ventilation strategies such as alveolar recruitment manoeuvre (RM), individualised PEEP application and low tidal volume are recommended. RM aims to increase lung compliance and prevent atelectasis by reopening collapsed alveoli. However, changes in haemodynamic parameters, especially mean arterial pressure and cardiac output, may occur during RM. In addition to standard monitoring for the management of these changes, haemodynamic evaluation can be performed with minimally invasive methods such as arterial waveform analysis. In this study, we aimed to evaluate the effects of RM applied during laparoscopic hysterectomy on intraoperative haemodynamic parameters using arterial waveform analysis.

Study Type

OBSERVATIONAL

Enrollment

Conditions

ASA Class I/II Patients Scheduled for Surgery Under General Anesthesia Laparoscopic Hysterectomy

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * ASA Class 1-2 patients 18-70 years old Exclusion Criteria: * \<18 y, BMI\>40 * Patients receiving invasive mechanical ventilator support in the last 1 month * Patients who have received chemotherapy or radiotherapy in the last 2 months * Those with severe lung disease (COPD, asthma, pulmonary infection, bronchiectasis, previous need for non-invasive mechanical ventilation, oxygen therapy or steroid therapy for acute attack) * Known severe pulmonary hypertension * Patient refusal to participate in the study * Intracranial tumour * Haemodynamic instability * Shock * Neuromuscular disease * Pathologies causing increased intracranial and intraocular pressure * Atrial fibrillation

Locations (1)

Balikesir University

Balıkesir, Turkey (Türkiye)

Outcomes

Primary Outcomes

Effect of RM on heart rate (in bpm)

measurement of heart rate in bpm

Time frame: perioperatively

Effect of RM on pressure mmHg

blood pressure measurement in mmmercury

Time frame: perioperatively

Effect of RM on Cardiac index(CI)

Cardiac Index measurement via an arterial cannula as l/min/m2

Time frame: intraoperatively

Effect of RM on stroke volume index(SVI)

SVI measurement via arterial cannula as L/min/m2

Time frame: intraoperatively

Effect of RM on pulse pressure variablity(PPV)

pulse pressure variability measured by finger probe as cm/s

Time frame: intraoperatively

Effect of RM on systemic vascular resistance index(SVRI)

systemic vascular resistance index(SVRI) measurement via arterial cannula as L/min/m2

Time frame: intraoperatively

Effect of RM on cardiac power index(CPI)

cardiac power index(CPI) measurement via arterial line as ml/min/m2

Time frame: intraoperatively

Secondary Outcomes

Effect of RM on Compliance

measurement of dynamic compliance by Ventilator as Cdyn

Time frame: intraoperatively

Data from ClinicalTrials.gov

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