Evaluation of the Effects of Different Ventilation Modes Used During Anesthesia Awakening on the Frequency of Postoperative Atelectasis

NCT ID: NCT06358027

Last Updated: 2024-04-10

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 278 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2024-04-05
• Study Completion Date: 2024-04-30

Brief Summary

In our study, we aimed to detect atelectasis developing in patients undergoing surgery under general anesthesia using transthoracic lung ultrasonography and to investigate the effect of ventilation methods used during recovery from anesthesia on the formation of postoperative atelectasis.

Detailed Description

Postoperative atelectasis is one of the most common pulmonary complications seen in surgical patients. Postoperative pulmonary complications and possible respiratory side effects have long been associated with anesthesia. Pulmonary complications are an important cause of morbidity and mortality in the postoperative period. The incidence of postoperative pulmonary complications due to long-term anesthesia varies between 5% and 80%, depending on the patient population, the surgery performed, and the criteria used to define the complication. It is known that the recovery period makes a significant contribution to the total amount of postoperative atelectasis. Spontaneously breathing patients are under the influence of anesthetic agents and neuromuscular blockers and cannot regain their functional residual capacity. For this reason, it is emphasized that atelectasis may develop in the postoperative period in cases whose anesthesia application is terminated by applying a spontaneous breathing period. Pressure support ventilation (PSV) is widely used for ventilator weaning in the intensive care unit (ICU) and has recently been available on anesthesia machines.

It is expected that the use of lung ultrasonography in operating rooms can reduce the complications that may develop in the postoperative period with evidence-based detection and early postoperative detection of atelectasis in the early postoperative period.

In this study, it was aimed to compare the effect of pre-extubation ventilation mode applied by anesthesia practitioners with ultrasound in the postoperative period on the frequency of atelectasis in adult patients who underwent surgery and whose lungs were evaluated as normal by ultrasound in the preoperative observation room. Modified LUS scores were used as lung ultrasonography evaluation criteria in the study.

Conditions

Atelectasis, Postoperative Pulmonary

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

pressure support ventilation group

when the patients were ready for extubation, anesthesia was terminated by one of the selected pressure support ventilation

lung ultrasound

Intervention Type: DIAGNOSTIC_TEST

The patients included in the study underwent lung imaging with lung ultrasound score twice, in the preoperative preparation room and in the postoperative recovery unit.Both lungs were determined as anterior and posterior axillary lines as anatomical markers and divided into a total of 12 regions, 4 in the anterior thoracic wall, 4 in the lateral wall, and 4 in the posterior region. In our study, we will use the modified LUS scoring, which has been shown to be more sensitive in the diagnosis of postoperative atelectasis in the recovery unit, based on existing literature reviews. The degree of the atelectasis will be determined according to do modified lung ultrasound score. Lung ultrasound score imaging of all patients was performed by the same anesthesiologist.

manual ventilation group

when the patients were ready for extubation, anesthesia was terminated by one of the selected manual ventilation wake-up methods at the initiative of the relevant anesthesiologist.

lung ultrasound

Intervention Type: DIAGNOSTIC_TEST

The patients included in the study underwent lung imaging with lung ultrasound score twice, in the preoperative preparation room and in the postoperative recovery unit.Both lungs were determined as anterior and posterior axillary lines as anatomical markers and divided into a total of 12 regions, 4 in the anterior thoracic wall, 4 in the lateral wall, and 4 in the posterior region. In our study, we will use the modified LUS scoring, which has been shown to be more sensitive in the diagnosis of postoperative atelectasis in the recovery unit, based on existing literature reviews. The degree of the atelectasis will be determined according to do modified lung ultrasound score. Lung ultrasound score imaging of all patients was performed by the same anesthesiologist.

Interventions

lung ultrasound

The patients included in the study underwent lung imaging with lung ultrasound score twice, in the preoperative preparation room and in the postoperative recovery unit.Both lungs were determined as anterior and posterior axillary lines as anatomical markers and divided into a total of 12 regions, 4 in the anterior thoracic wall, 4 in the lateral wall, and 4 in the posterior region. In our study, we will use the modified LUS scoring, which has been shown to be more sensitive in the diagnosis of postoperative atelectasis in the recovery unit, based on existing literature reviews. The degree of the atelectasis will be determined according to do modified lung ultrasound score. Lung ultrasound score imaging of all patients was performed by the same anesthesiologist.

Intervention Type: DIAGNOSTIC_TEST

Other Intervention Names

Modified Transthoracic Ultrasound Scoring System

Eligibility Criteria

Inclusion Criteria

• Patients undergoing general anesthesia with supine position
• Endotracheal intubations and mechanical ventilation during general anesthesia
• Operation time is more than 2 hours

Exclusion Criteria

• Patients who will undergo surgical intervention under emergency conditions
• Pregnancy
• Upper respiratory tract disease in the last 3 weeks
• Previous lung surgery
• Advanced cardiac and/or pleural lung disease and chest wall deformity, and primary or metastatic lung cancer

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Dokuz Eylul University

OTHER

Sponsor Role: lead

Responsible Party

Busra Otlu

Assistant professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Other Identifiers

DokuzEU-ACC-BOtlu-01

Identifier Type: -

Identifier Source: org_study_id