Peroperative Use of Positive End-expiratory Pressure Prevents Formation of Atelectasis as Studied by Computerised Tomography at End of Surgery
NCT ID: NCT02548416
Last Updated: 2017-11-21
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
24 participants
INTERVENTIONAL
2015-11-30
2016-11-30
Brief Summary
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The investigators hypothesize that the use of PEEP as a single intervention improves oxygenation and prevents atelectasis as investigated by computed tomography compared to a control group with zero PEEP.
Detailed Description
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Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
DOUBLE
Study Groups
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PEEP group
Induction and maintenance of anaesthesia in a conventional manner. Peroperative ventilatory settings using positive end-expiratory pressure.
Positive end-expiratory pressure
Induction of anaesthesia is performed in a conventional manner using a target controlled infusion of propofol and remifentanil. Intubation of the trachea is facilitated by rocuronium.
As soon as correct position of the endotracheal tube is confirmed, controlled ventilation is started with a tidal volume of 7 mL/kg body weight and a respiratory frequency of 10. The fresh gas flow is set to 1 litre/min with an oxygen mixture of 40%, aiming for an inspired oxygen fraction (FiO2) of 30-35%. Positive end-expiratory pressure is set to 6 or 8 cm H20 (8 if BMI\>25) in the intervention group.
Unless the patient´s SpO2 falls below 90%, the FiO2 remains unchanged throughout the procedure.
Control group zero PEEP
Induction and maintenance of anaesthesia in a conventional manner. Peroperative ventilatory settings using zero end-expiratory pressure.
Control group, zero PEEP
Induction of anaesthesia is performed in a conventional manner using a target controlled infusion of propofol and remifentanil. Intubation of the trachea is facilitated by rocuronium. As soon as correct position of the endotracheal tube is confirmed, controlled ventilation is started with a tidal volume of 7 mL/kg body weight and a respiratory frequency of 10. The fresh gas flow is set to 1 litre/min with an oxygen mixture of 40%, aiming for an inspired oxygen fraction (FiO2) of 30-35%. Zero PEEP is used.
Unless the patient´s SpO2 falls below 90%, the FiO2 remains unchanged throughout the procedure.
Interventions
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Positive end-expiratory pressure
Induction of anaesthesia is performed in a conventional manner using a target controlled infusion of propofol and remifentanil. Intubation of the trachea is facilitated by rocuronium.
As soon as correct position of the endotracheal tube is confirmed, controlled ventilation is started with a tidal volume of 7 mL/kg body weight and a respiratory frequency of 10. The fresh gas flow is set to 1 litre/min with an oxygen mixture of 40%, aiming for an inspired oxygen fraction (FiO2) of 30-35%. Positive end-expiratory pressure is set to 6 or 8 cm H20 (8 if BMI\>25) in the intervention group.
Unless the patient´s SpO2 falls below 90%, the FiO2 remains unchanged throughout the procedure.
Control group, zero PEEP
Induction of anaesthesia is performed in a conventional manner using a target controlled infusion of propofol and remifentanil. Intubation of the trachea is facilitated by rocuronium. As soon as correct position of the endotracheal tube is confirmed, controlled ventilation is started with a tidal volume of 7 mL/kg body weight and a respiratory frequency of 10. The fresh gas flow is set to 1 litre/min with an oxygen mixture of 40%, aiming for an inspired oxygen fraction (FiO2) of 30-35%. Zero PEEP is used.
Unless the patient´s SpO2 falls below 90%, the FiO2 remains unchanged throughout the procedure.
Eligibility Criteria
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Inclusion Criteria
* Patients scheduled for non-abdominal day case surgery under general anaesthesia.
Exclusion Criteria
* Body Mass Index (BMI) 30 or higher.
* Arterial oxygen saturation (SpO2) \<96% breathing air.
* Chronic Obstructive Pulmonary Disease (COPD).
* Ischaemic heart disease.
* Known or anticipated difficult airway.
* Active smokers and ex-smokers with a history of more than 6 pack years.
* Need for interscalene or supraclavicular plexus block for postoperative pain relief (risk of phrenic nerve paralysis).
40 Years
75 Years
ALL
No
Sponsors
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Region Västmanland
OTHER
Responsible Party
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Erland Ostberg
M.D.
Principal Investigators
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Lennart Edmark
Role: STUDY_DIRECTOR
Region Västmanland
Locations
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Region Västmanland
Köping, , Sweden
Countries
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Other Identifiers
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Dnr 2015/338
Identifier Type: -
Identifier Source: org_study_id