Postoperative Atelectasis in Pediatric Patients With Prone Position

Pulmonary Atelectasis, Postoperative Clinical Trial

Official title:

Postoperative Atelectasis in Pediatric Patients With Prone Position : Effect of Repetitive Alveolar Recruitment by Lung Ultrasound

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03486847
• Other study ID #: H-1802-088-923
• Status: Completed
• Phase: N/A
• Start date: March 29, 2018
• Est. completion date: July 31, 2019

Study information

• Verified date: April 2020
• Source: Seoul National University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study evaluates the incidence of postoperative atelectasis after general anesthesia with prone position using lung ultrasound in children age < 3 years.

Description:

Atelectasis is common in pediatric patients after general anesthesia. Particularly, infants are more likely to develop atelectasis or ventilation-perfusion imbalance after general anesthesia because of the immature ribs and respiratory muscles, the high compliance of the rib cage and a significant reduction in functional residual capacity (FRC) during general anesthesia. Previous studies have reported that alveolar recruitment and positive end-expiratory pressure (PEEP) can be used to reduce atelectasis in children. Also, previous studies have shown that the lung ultrasound can be used to evaluate the degree of atelectasis during general anesthesia in children.

However, none of the previous studies investigated the incidence of atelectasis, the effect of alveolar recruitment, and the PEEP in pediatric patients under general anesthesia with prone position. The purpose of this study was to evaluate previously described parameters using lung ultrasound.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 74
• Est. completion date: July 31, 2019
• Est. primary completion date: July 31, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A to 3 Years

Eligibility

Inclusion Criteria:

• Children undergoing general anesthesia with prone position

• Endotracheal intubation and mechanical ventilation during general anesthesia

• Operation time is more than 2 hours

Exclusion Criteria:

• Previous lung surgery

• Any abnormal findings such as atelectasis, pneumothorax, pleural effusion, or pneumonia on preoperative chest X-ray

• Researchers judge (to be inappropriate)

Related Conditions & MeSH terms

• Atelectasis, Compression
• Pulmonary Atelectasis
• Pulmonary Atelectasis, Postoperative

Intervention

Procedure:
• Repetitive recruitment with PEEP
Apply sustained airway pressure of 30-40 cmH2O for 10-20 seconds before suegery and once an hour during surgery. PEEP is set to 7 cmH2O.
• One recruitment with PEEP
Apply sustained airway pressure of 30-40 cmH2O for 10-20 seconds before surgery. PEEP is set to 7 cmH2O.

Locations

Country	Name	City	State
Korea, Republic of	SNUH	Seoul	Jongnogu

Sponsors (1)

Lead Sponsor	Collaborator
Seoul National University Hospital

Country where clinical trial is conducted

Korea, Republic of, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Incidence of pre-extubation atelectasis	Incidence of pre-extubation atelectasis accessed by lung ultrasound	postoperative 10 minutes
Secondary	Incidence of intraoperative atelectasis after intubation	Incidence of intraoperative atelectasis after induction accessed by lung ultrasound	intraoperative
Secondary	Incidence of intraoperative atelectasis after position change to prone	Incidence of intraoperative atelectasis after position change to prone accessed by lung ultrasound	intraoperative
Secondary	Incidence of intraoperative and postoperative (within 12hr) desaturation	Oxygen saturation by pulse oximetry (SpO2) = 95% or 10% below the baseline value	intraoperative and postoperative (within 12hr)
Secondary	Incidence of intraoperative hypotension	Systolic blood pressure (SBP) = 20% below the baseline value	intraoperative