Lung Diseases Clinical Trial
Official title:
Impact of Lung Recruitment Maneuvers on Driving Pressure in Cardiac Surgery (IMPREMO): Before - After Trial
In anesthesia the incidence of postoperative pulmonary complications is frequent, especially
in cardiac surgery where the incidence can reach 10%. Respiratory morbidity in cardiac
surgery is favored by multiple factors and is higher compared to anesthesia in "general"
surgery. The prevention of these complications is a major challenge in the management of
patients.
Influence of driving pressure level on respiratory morbidity was first demonstrated in
management of acute respiratory distress syndrome (ARDS) in resuscitation.
More recently, this notion has been introduced in anesthesia, with a correlation between
increase driving pressure level and increase of post-operative respiratory complications.
A method should reduce these levels of driving pressure: performing lung recruitment
maneuvers. This technique has been successfully tested in abdominal surgery in particular in
a study published by Futier et al.. They systematized and standardized lung recruitment
maneuvers and showed a decrease of postoperative pulmonary complications in abdominal
surgery.
Thus, the realization of lung recruitment maneuvers, already used at the discretion of the
practitioner, is now recommended by several teams of experts. The investigators propose in
this "before-after" trial to evaluate variation in driving pressure due to systematic use of
lung recruitment maneuvers, observed in patients operated in elective or urgent surgery. The
secondary objective is to evaluate their impact on postoperative pulmonary complications.
This is a retrospective, before / after, monocentric trial. ;
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