Clinical Trial Details
— Status: Recruiting
Administrative data
| NCT number |
NCT06462976 |
| Other study ID # |
2024/99 |
| Secondary ID |
|
| Status |
Recruiting |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
August 10, 2024 |
| Est. completion date |
December 10, 2025 |
Study information
| Verified date |
June 2024 |
| Source |
TC Erciyes University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
The aim of this study is to investigate the effect of different surgical positions
(supine/prone) on lung mechanical power (MP) and its relationship with postoperative
pulmonary complications in patients planned to percutaneous nephrolithotomy (PNL) under
general anesthesia.
Description:
PNL is the preferred treatment method for kidney stones larger than 2 cm, multiple kidney
stones and staghorn stones. With new developments in the field of medicine, PNL has become a
minimally invasive method and is preferred to open surgery in the treatment of kidney stones.
Alternative types of anesthesia and various patient positions have been described in PNL.
Mechanical power of ventilation (MP) is the amount of energy transferred from the mechanical
ventilator to the respiratory system per unit time. Although this energy is primarily used to
overcome airway resistance and respiratory system compliance, some of it acts directly on
lung tissue, potentially causing ventilator-induced lung injury (VILI).
Mechanical power during ventilation estimates the energy delivered to the respiratory system
by integrating inspiratory pressures, tidal volume and respiratory rate into a single value.
It allows physicians to evaluate adjustments made to mechanical ventilation by calculating a
single value. High mechanical power value is associated with a high incidence of
postoperative pulmonary complications and mortality . In short, the energy distributed to the
respiratory system consists of the static composite (PEEP), the dynamic composite (driving
pressure and tidal volume) and the resistive composite (the pressure required for gas flow).
Because energy is equal to the pressure that causes a change in volume. The equation is as
follows: MP= 0.098 × respiratory rate × tidal volume × (PEEP + ½(plateau-peep)+
(peak-plateau)). These parameters are monitored on the monitor while the patient is
mechanically ventilated and placed into the equation.
After general anesthesia, some postoperative pulmonary complications may be encountered.
Exposure to high mechanical force in ventilated patients during surgery has been found to be
associated with an increase in postoperative pulmonary complications and acute respiratory
failure. This increases the length of hospital stay and mortality. In order to prevent
ventilator-related lung damage, the mechanical ventilator must be adjusted to transfer the
least amount of energy per unit time to the respiratory system for each patient.
Early recognition of postoperative pulmonary complications that are likely to occur after
surgery is important for rapid initiation of treatment. Incentive spirometry (triflo) can be
used to make a rapid assessment of the respiratory capacity of patients. An incentive
spirometer is a device that measures the volume of air drawn into the lungs during
inspiration. As you breathe through an incentive spirometer, a piston inside the device rises
and measures the volume of inhaled air. 1 ball is considered as 600ml, 2 balls as 900ml, and
3 balls as 1200ml flow.]
