Detecting Lung's Closing Pressure by Capnography

Atelectasis Clinical Trial

Official title:

Analysis of CO2/Volume and CO2-pressure Curves to Detect the Lung's Closing Pressure in Ventilated Patients

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05873998
• Other study ID #: CP2023
• Status: Recruiting
• Start date: February 28, 2023
• Est. completion date: October 1, 2023

Study information

• Verified date: February 2023
• Source: Hospital Privado de Comunidad de Mar del Plata
• Contact: Gerardo Tusman, MD
• Phone: 542234990074
• Email: gtusman[@]hotmail.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

General anesthesia is associated with loss of pulmonary functional residual capacity and the consequent development of atelectasis and closure of the small airway.

Mechanical ventilation in a lung with reduced functional residual capacity and atelectasis increased the dynamic alveolar stress-strain, inducing a local inflammatory response in atelectatic lung areas known as ventilatory-induced lung injury. This phenomenon may appear even in healthy patients undergoing general anesthesia and predisposes them to hypoxemic episodes that can persist in the early postoperative period.

Lung recruitment maneuvers restore the functional residual capacity and, therefore, protect the lungs from lung injury. A key issue in this kind of treatment is detecting the lung's closing pressure in order to maintain the end-expiratory pressure above such a limit.

Description:

This is a prospective and observational study designed to measure the lung's closing pressure. The investigators will study 20 mechanically ventilated patients scheduled for mediastinoscopy surgery under general anesthesia.

Lung mechanics and capnography will be assessed during surgery. A slow pressure-volume curve will be automatically performed by the ventilator, and the small airway closing pressure will be determined as the inflection point in the alveolar slope of the pressure-CO2 and volume-CO2 curves. Then, a lung recruitment maneuver will be applied following a descending positive end-expiratory pressure trial to determine the lung's closing pressure. The investigator will see if the lung's closing pressure found with these two techniques is similar.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 20
• Est. completion date: October 1, 2023
• Est. primary completion date: September 1, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 70 Years

Eligibility

Inclusion Criteria:

• Age > 17 years ole

• Programmed surgery

Exclusion Criteria:

• Pregnancy

• No programmed surgery

• Hemodynamic instability

• Severe COPD

• Acute respiratory infection

Related Conditions & MeSH terms

• Atelectasis
• Pulmonary Atelectasis

Intervention

Diagnostic Test:
• Slow pressure-volume curve
Patients will be sequentially subjected to a slow pressure-volume curve and a lung recruitment maneuver

Locations

Country	Name	City	State
Argentina	Hospital Privado de Comunidad	Mar del Plata	Buenos Aires

Sponsors (1)

Lead Sponsor	Collaborator
Hospital Privado de Comunidad de Mar del Plata

Country where clinical trial is conducted

Argentina, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Airway pressure	Airway pressure will be measured at the airways opening and expressed in cmH2O.	30 minutes
Primary	Carbon dioxide	Expired carbon dioxide will be measured at the airways opening by a main-stream capnograph, expressed in mmHg.	30 minutes