Effect of Extubation on Respiratory Function

Study Overview
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Brief Summary
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The extubation phase is a risky period of anesthesia management. During this step, serious complications can arise: hypoxemia, laryngospasm, pharyngeal obstruction, pneumonia… In spite of these complications, extubation and its impact on respiratory function, particularly on the Functional Residual Capacity (FRC), remains poorly studied because of the difficulty to make bedside measurements. The PulmoVista 500 is a clinical routine which provide effective non-invasive bedside measurements. It would be interesting to evaluate the impact of extubation on respiratory function, and more specifically FRC changes during and after extubation. This study will allow a better physiopathological knowledge and a quality improvement patient extubation management.

Detailed Description
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The aim of this study is to evaluate the variation of functional residual capacity and its distribution before and after extubation. Patients with scheduled surgery and receiving general anesthesia with orotracheal intubation are included and the measurements will be performed in the post-interventional monitoring room (PICU). EELI data will be collected before extubation and then at T0, then T5, T10, T15 and T20 minutes. No subsequent follow-up is required.

Official Title
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Electrical Impedance Tomography: Effect of Extubation on Functional Residual Capacity

Conditions
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Functional Residual Capacity

Intervention / Treatment
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* Other: Functional residual capacity measure by electrical impedance tomography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient over 18 years Patient in operating room for scheduled surgery Patient receiving general anaesthesia with orotracheal intubation Patient given written consent after information Patient covered by social security or equivalent regimen Exclusion Criteria: Patient undergoing thoracic and spinal surgery, due to the presence of dressings that interfere with measurements, Patient who has undergone intracerebral surgery because of possible communication difficulties upon awakening, Patients with a body mass index (BMI) > 50 (measurements not possible) Pregnant or breastfeeding patient, Patient contraindicated to the use of a thoracic electroimpedancemetry technique: dressings, wounds, presence of a pacemaker, defibrillator or any other active implant. Patient deprived of liberty by a judicial or administrative decision or patient subject to a legal protection measure (guardianship, curatorship...) Patient in a period of exclusion from another research protocol Any other reason that, in the opinion of the investigator, could interfere with the evaluation of study objectives

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Functional residual capacity<br>Functional residual capacity measure during and after extubation | Other: Functional residual capacity measure by electrical impedance tomography<br>* Patient functional residual capacity will be measured by electrical impedance tomography before extubation and then at 0, 10, 15 and 20 min after extubation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| End Expiratory Lung Impedance (EELI) | EELI variation before and at different timepoints after extubation: T0, T5, T10, T15 and T20 (min). | Between 2 and 3 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tidal volume distribution | Percentage of tidal volume in the different regions of interest before extubation and at different timepoints after it: T0, T5, T10, T15 and T20 (min). | Between 2 and 3 hours | 
| Tidal volume distribution depending on patient position | Percentage of tidal volume according to patient position: supine with or without proclivity, lateral or ventral decubitus | Between 2 and 3 hours | 
| Tidal volume distribution depending on surgery type and duration | Percentage of tidal volume according to type and duration of surgery | Between 2 and 3 hours | 
| Tidal volume distribution depending on ventilatory mode | Percentage of tidal volume according to the ventilatory mode: controlled ventilation, spontaneous ventilation with inspiratory assistance, spontaneous ventilation of extubated patient with or without oxygenation device | Between 2 and 3 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Extubation, Functional residual capacity, Electrical impedance tomography, Pulmovista, Respiratory function