The Effects of Pre-extubation Single Recruitment Maneuver on Perioperative Atelectasis

NCT ID: NCT05494255

Last Updated: 2023-05-06

Study Results

Results pending

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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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-11

Study Completion Date

2023-05-04

Brief Summary

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Laparoscopic surgeries may cause atelectasis on the lungs which may stay clinically occult after the surgery. Lung Ultrasound Scoring (LUS) can provide an objective measuring system to understand the condition of the lungs in the perioperative period. In this randomized controlled study, it is aimed to investigate the effects of one single recruitment maneuver (RM) just before emergence and extubation (at the end of surgery) on LUS scores and postoperative recovery room oxygenation in laparoscopic nephrectomy surgeries. Accordingly, the intervention group will be applied single RM before extubation, while the control group will be awaken without RM.

There will be LUS evaluation at 4 different time for intervention group (Group RM) points that are:

T1: 5 min after the intubation T2: At the end of surgery (After skin closure, before recruitment maneuver) T3(RM): After recruitment maneuver, before extubation T4: 30 minutes after extubation in the recovery room

LUS evaluation will be made at 3 different time points in control group (Group NoRM):

T1: 5 min after the intubation T3(NoRM): Before extubation (no recruitment maneuvers will be made) T4: 30 minutes after extubation in the recovery room.

The primary outcome is the comparison of the T3 LUS scores. Assuming a 40% difference in the T3 LUS score, total number of 30 patients were calculated to be included in the study with an alpha value of 0.05 and 95% power. A possible drop-out of 5 patients per group, 20 patients were planned to be enrolled in each group.

Secondary outcomes will include; difference in T4 LUS scores, the effect of RM on postoperative recovery room oxygenation, and the effect of deltaLUS (T3-T2) on postoperative recovery room oxygenation.

Detailed Description

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Conditions

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Pulmonary Atelectasis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled trial
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Group RM

One single recruitment maneuver will be applied in this group at the end of the surgery and before the extubation

Group Type ACTIVE_COMPARATOR

Recruitment maneuver

Intervention Type OTHER

In Group RM (intervention group) after skin closure, mechanical ventilation settings will be set to FiO2:100%, I:E=1:1, respiratory rate: 6, and then tidal volume will be increased gradually by 150 ml until reaching a plato pressure of 30 mmHg. After 3 breaths in this state, RM will be considered accomplished. LUS evaluation will be made just before and after the RM.

Group NoRM

Usual care will be applied in this group

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Recruitment maneuver

In Group RM (intervention group) after skin closure, mechanical ventilation settings will be set to FiO2:100%, I:E=1:1, respiratory rate: 6, and then tidal volume will be increased gradually by 150 ml until reaching a plato pressure of 30 mmHg. After 3 breaths in this state, RM will be considered accomplished. LUS evaluation will be made just before and after the RM.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* \>18 years old
* Laporoscopic nephrectomy patients who will be operated in lateral positions
* Elective, semi-elective surgeries

Exclusion Criteria

* Patients with emphysema
* Patients with documanted heart failure
* Patients requiring intraoperative multiple recruitment maneuver due to hypoxemia
* Patients with hemodynamic instability
* Patients with pneumothorax risk
* Emergency surgery
* Patients requiring intraoperative liberal fluid therapy (\>10 cc/kg/hr)
* Patients requiring blood products
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istanbul University

OTHER

Sponsor Role lead

Responsible Party

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Emre Sertaç Bingül

Principal investigator, Lecturer, Medical Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Istanbul University Istanbul Faculty of Medicine

Istanbul, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Other Identifiers

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2022/1066

Identifier Type: -

Identifier Source: org_study_id

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