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Effect of Different Peep Values on Gastric Residual Volume

NCT ID: NCT06371378

Last Updated: 2024-10-15

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

111 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-05

Study Completion Date

2024-09-01

Brief Summary

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The aim of this study was to predict the effect of gastric antrum diameter before extubation on intra-abdominal pressure changes and consequently on the risk of pulmonary aspiration in patients undergoing elective spinal surgery under general anaesthesia in the prone position in the Neurosurgery Operating Theatre of the Ministry of Health Ankara City Hospital and to take precautions accordingly. Gastric antrum diameter and intraabdominal pressure measurements may contribute to the improvement of anaesthetic practice by reducing the risk of pulmonary aspiration and additional complications.

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Detailed Description

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Prone positioning in spinal surgery is a very important issue for anaesthetists. Although there are many conditions that are taken into consideration in patient follow-up, it is a position frequently used in the treatment of pulmonary diseases other than surgery. PEEP application in the prone position is especially used in the treatment of conditions such as acute respiratory distress syndrome (ARDS). This treatment method basically aims to improve oxygenation and ventilation in the lungs. While providing improvement in the lungs, it may indirectly lead to some changes in the gastrointestinal system. Depending on PEEP levels, intra-abdominal pressure may increase and subsequently cause reflux of gastric contents or gastroparesis. The prone position itself also increases the risk of reflux. Gastric POCUS (Point of Care Ultrasound) is a noninvasive method that gives us information about the stomach contents and can be easily performed at the bedside. Both patient position and respiratory parameters, such as PEEP, may have an effect on gastric POCUS. Visualization of gastric content or detection of gastric retention allows us to predict possible pulmonary aspiration complications before extubation, and gastric POCUS may be a valuable marker before extubation in patients who remain in prone positions for a long time. The aim of this study was to determine the effect of PEEP application on the antrum diameter evaluated by gastric POCUS and the risk of aspiration before extubation in patients undergoing spinal surgery in the prone position.

Conditions

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Respiratory Aspiration of Gastric Content

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

We gave three different peep values on the mechanic ventilator; 3 groups: Group I: PEEP O, Group II: PEEP 4, Group III: PEEP 8
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
single blind

Study Groups

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GROUP I: PEEP 0

Patients will receive 0 cmH20 PEEP

Group Type ACTIVE_COMPARATOR

PEEP 0

Intervention Type PROCEDURE

PEEP 0 CMH20 will be used During Surgery

GROUP II: PEEP 4

Patients will receive 4 cmH20 PEEP

Group Type ACTIVE_COMPARATOR

PEEP 4

Intervention Type PROCEDURE

PEEP 4 CMH20 will be used During Surgery

GROUP III: PEEP 8

Patients will receive 8 cmH20 PEEP

Group Type ACTIVE_COMPARATOR

PEEP 8

Intervention Type PROCEDURE

PEEP 8 CMH20 will be used During Surgery

Interventions

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PEEP 0

PEEP 0 CMH20 will be used During Surgery

Intervention Type PROCEDURE

PEEP 4

PEEP 4 CMH20 will be used During Surgery

Intervention Type PROCEDURE

PEEP 8

PEEP 8 CMH20 will be used During Surgery

Intervention Type PROCEDURE

Other Intervention Names

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antrum diamater radio , gastric reziduel volume

Eligibility Criteria

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Inclusion Criteria

* 18-65 years of age
* ASA I-II risk group

Exclusion Criteria

* Asthma
* COPD
* Gastroesophageal reflux
* Gastric herniation
* Gastric surgery,
* Intracranial tumor
* Epilepsy
* Neuromuscular disease
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ankara City Hospital Bilkent

OTHER

Sponsor Role lead

Responsible Party

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Süleyman Taygurt

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ankara City Hospital

Ankara, Çankaya, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Chui J, Craen RA. An update on the prone position: Continuing Professional Development. Can J Anaesth. 2016 Jun;63(6):737-67. doi: 10.1007/s12630-016-0634-x. Epub 2016 Apr 12.

Reference Type BACKGROUND
PMID: 27072147 (View on PubMed)

Fujishima S. Guideline-based management of acute respiratory failure and acute respiratory distress syndrome. J Intensive Care. 2023 Mar 10;11(1):10. doi: 10.1186/s40560-023-00658-3.

Reference Type BACKGROUND
PMID: 36895001 (View on PubMed)

El-Boghdadly K, Wojcikiewicz T, Perlas A. Perioperative point-of-care gastric ultrasound. BJA Educ. 2019 Jul;19(7):219-226. doi: 10.1016/j.bjae.2019.03.003. Epub 2019 Apr 24. No abstract available.

Reference Type BACKGROUND
PMID: 33456894 (View on PubMed)

Other Identifiers

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gastric residual volume

Identifier Type: -

Identifier Source: org_study_id

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