Respiratory Insufficiency Clinical Trial
Official title:
Perioperative Change of Regional Ventilation During Spontaneous Breathing
Perioperative changes in regional ventilation by pulmonary electrical impedance tomography and spirometry will be investigated in patients at risk for postoperative pulmonary complications. Those patients undergo abdominal and limb operations. In a pilot study arm electrical impedance tomography is tested in patients receiving osteosynthesis of serial rib fractures.
Postoperative pulmonary complications (Defined as pulmonary infection, pleural effusion,
atelectasis, pneumothorax, bronchospasm, aspiration pneumonitis or respiratory insufficiency
subsequent to surgery) increase the morbidity and mortality of surgical patients. Several
independent factors determined by the patients' characteristics and the operative procedure
increase the risk for those complications. The postoperative decrease of values measured by
spirometry, such as the forced vital capacity (FVC) and forced expiratory volume in one
second (FEV1), were found in patients after major surgical procedures for several days. The
postoperative reduction of those measurement can be the result of general functional
limitations in those patients (e.g. by postoperative pain) or the result of a regional
postoperative pulmonary complication (e.g. atelectasis, pleural effusion). The method of the
electrical impedance tomography (EIT) enables to visualize the regional ventilation within a
transversal section of the lung in real time. Studies examining the change of pulmonary EIT
for several days postoperatively in spontaneously breathing patients are lacking. The aim of
the present study is to examine perioperative changes in regional ventilation in
spontaneously breathing patients during their recovery after abdominal and limb surgery.
Moreover, the association of those changes with expected changes in spirometry is tested.
Finally, in patients with evident postoperative pulmonary complications the value of
pulmonary EIT to detect those changes is investigated. The study should improve the
knowledge about the development of postoperative pulmonary complications and test the
scientific and clinical value of pulmonary EIT in those spontaneously breathing patients.
In a group of patients undergoing osteosynthesis of a flail chest, it is tested how regional
ventilation changes by these operations and whether pulmonary EIT is actually usable in
these patients.
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