Role of Lung Ultrasound Imaging in the Comparison of Two Mechanical

Status Completed

Clinical Trial Summary

The use of positive end-expiratory pressure (PEEP) and recruitment maneuvers during laparotomy will limit the development of atelectasis and therefore improve the aeration score.

Clinical Trial Description

Postoperative pulmonary complications contribute to the morbidity of surgical patients. During general anesthesia, up to 90% of patients will develop atelectasis, which is thought to be a major contributing factor to their development. The adjustment of ventilator settings to prevent the occurrence of atelectasis and reduce pulmonary complications remains controversial. Despite the use of similar mechanical ventilation strategies, two recent studies (IMPROVE, PROVHILO) involving 1300 patients diverged in their conclusions regarding the impact of these strategies in the prevention of pulmonary complications. In these studies, the absence of imagery to assess the pulmonary end-result of the different ventilation strategies complicates the interpretation of their results.

On arrival in the operating theatre, each patient will undergo a baseline lung ultrasound examination. The anesthetic technique and monitoring will be standardized. The radial artery will be cannulated after induction of anesthesia for blood gas monitoring. Ventilator settings will be adjusted according to randomization.

A second lung ultrasound examination will be performed 5 minutes following induction of general anesthesia. In the PEEP group, a lung ultrasound examination will be performed immediately following the first recruitment maneuver. A lung ultrasound examination will also be performed at the end of surgery before emergence of general anesthesia.

Fifteen minutes after arrival in the recovery room, a last lung ultrasound examination will be performed. Fraction of inspired oxygen (FiO2) and vital signs will be recorded during each ultrasound examination. Arterial blood samples will be collected simultaneously. The aeration score will be calculated for each lung ultrasound examination. ;

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT02055807
Study type	Interventional
Source	Centre hospitalier de l'Université de Montréal (CHUM)
Contact
Status	Completed
Phase	N/A
Start date	February 2015
Completion date	December 2015

View Details

See also
Status	Clinical Trial	Phase
Recruiting	`NCT06021249` - Comparing Innovative and Traditional Ventilation Strategies on Atelectasis and Prognosis in Elderly Patients	N/A
Terminated	`NCT03581474` - Evaluation of BAL Procedure With Ambu aScope 3 Large in Patients in an ICU Setting	N/A
Completed	`NCT02871258` - MetaNeb® Chest X-ray Study	N/A
Completed	`NCT02523755` - Evaluation of Regional Distribution of Ventilation During Labor With or Without Epidural Analgesia	Phase 4
Completed	`NCT02232841` - Electrical Impedance Imaging of Patients on Mechanical Ventilation	N/A
Completed	`NCT02216006` - High Fresh Gas Flow After Intubation	N/A
Completed	`NCT01416519` - Physiotherapy Technique Decreases Respiratory Complications After Cardiac Operation	N/A
Completed	`NCT03153592` - Effects of Mechanical Ventilation Guided by Transpulmonary Pressure on Gas Exchange During Robotic Surgery: a Pilot Study	N/A
Completed	`NCT03694665` - Monitoring Lung Recruitment Maneuver in Anesthetized Morbidly Obese	N/A
Completed	`NCT04506203` - The Accuracy of Pediatric Air Test as a Non-invasive Atelectasis Diagnostic Tool	N/A
Not yet recruiting	`NCT06296173` - Open Lung Protective Extubation Following General Anesthesia	N/A
Completed	`NCT04006665` - Role of Lung Ultrasonography in Diagnosing Atelectasis in Robotic Pelvic Surgeries
Completed	`NCT03614845` - Evaluation of Effect of Different Ventilator Mods on Atelectasis in Patients Undergoing Laparoscopic Surgery	N/A
Active, not recruiting	`NCT06075836` - AI Assisted Detection of Chest X-Rays
Completed	`NCT01993394` - Effect of Hyperoxia and Hypergravity on Lung Ventilation and Perfusion	N/A
Completed	`NCT00671723` - Dornase Alpha Versus Hypertonic Saline for Lung Atelectasis in Non-Cystic Fibrosis Patients	N/A
Completed	`NCT03378752` - Atelectasis Formation Using HFJV During Stereotactic Solid Organ Ablations
Completed	`NCT05963945` - Multi-Reader Retrospective Study Examining Carebot AI CXR 2.0.21-v2.01 Implementation in Everyday Radiology Clinical Practice
Completed	`NCT03592589` - Prevention of Atelectasis, Via High Flow Nasal Cannula to Obtain a PEP, During General Anesthesia in Children	N/A
Completed	`NCT04458623` - Air Test In Diagnosis Of Postoperative Lung Atelectasis	N/A

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

Role of Lung Ultrasound Imaging in the Comparison of Two Mechanical Ventilation Strategies During Laparotomy

Clinical Trial Summary

Clinical Trial Description

Study Design

Related Conditions & MeSH terms