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Evaluation of Respiratory Mechanics in Supine and PARK-bench Positions (SPARK) — SPARK  

Ventilator-Induced Lung Injury Clinical Trial

Official title:
Evaluation of Respiratory Mechanics in Supine and PARK-bench Positions in Patients Undergoing Elective Neurosurgery: a Cross-over Physiological Study

Clinical Trial Summary

The primary objective of this prospective observational physiological study is to evaluate the variation in regional distribution of intrapulmonary volume in the dependent and non-dependent lung regions in patients undergoing neurosurgical intervention between supine and Park-Bench position.

Clinical Trial Description

The Park-Bench position is a variant of the lateral position used in neurosurgical interventions where lesions of the posterior cranial fossa and ponto-cerebellar angle need to be approached. The patient is placed in a lateral-oblique position with the arm on the side they are lying on extending out of the operating bed and supported by an external support. The head is fixed in flexion and rotation with the Mayfield headrest immobilizing the head, allowing exposure of the surgical region of interest. In the lateral decubitus position, several factors contribute to changing respiratory mechanics: airway resistance increases and compliance decreases. Furthermore, the gravitational gradient is altered, which is one of the main factors in the regional distribution of intrapulmonary air volume and tidal volume distribution: the phenomenon of overdistension of the non-dependent lung and collapse of the dependent lung could occur. Fully understanding these physiological changes could optimize mechanical ventilation settings and thus avoid causing damage to lung parenchyma (Ventilator-Induced Lung Injury). The primary hypothesis of this physiological study is to evaluate changes in regional distribution of intrapulmonary volume when transitioning from the supine position to the Park-Bench position. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details
NCT number NCT06448988
Study type Observational
Source Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Contact Giuliano Ferrone, MD
Phone +390630151
Email giulianoferrone@gmail.com
Status Not yet recruiting
Phase
Start date July 1, 2024
Completion date July 31, 2025
View Details
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