Interest of Tracheal Extubation in Positive Pressure on Postoperative Oxygenation in Adult Digestive Surgery: Prospective Randomized Study ExPress

Study Overview
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Brief Summary
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Evaluation of a postoperative tracheal extubation protocol under positive pressure in accordance with international recommendations. Two arms: the first with classic extubation with disconnection of the respirator and the second with extubation without disconnection of the respiratory, as recommended. Computer Randomization with a 1: 1 ration

Official Title
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Interest of Tracheal Extubation in Positive Pressure on Postoperative Oxygenation in Adult Digestive Surgery: Prospective Randomized Study

Conditions
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Patients Undergoing Digestive Surgery With Orotracheal Intubation

Intervention / Treatment
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* Procedure: positive pressure extubation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age> 18 and <80 Patient going to benefit from general anesthesia with orotracheal intubation for surgery lasting more than 60 minutes at the visceral surgery unit of the Rouen University Hospital. Person affiliated to a social security scheme Person who has read and understood the newsletter and signed the consent form Exclusion Criteria: Minor patients or age> 80 years History of Obstructive Sleep Apnea Syndrome Chronic respiratory failure / History of chronic obstructive pulmonary disease Surgery < 60 minutes Use of methylene blue intraoperatively Extubation finally performed in the operating room orotracheal intubation difficult to induce general anesthesia Suspected inhalation during orotracheal intubation Pneumothorax per operative Heart failure authenticated by trans thoracic ultrasound <50% Neuromuscular pathologies (myasthenia gravis, myopathies) Body mass index> 35 Emergency surgery Patient with an ASA IV score (ie according to the definition of the American Society of Anesthesiology) Major surgical complications (hemorrhagic shock) Major anesthetic complications (anaphylactic shock, bronchospasm) Pregnant or parturient or lactating woman or woman of childbearing age without proven contraception Person deprived of their liberty by an administrative or judicial decision or person placed under the protection of justice / guardianship or curatorship

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Standard extubation Arm<br> | |
| Experimental: Positive pressure extubation arm<br> | Procedure: positive pressure extubation<br>* Two arms: the first with classic extubation with disconnection of the ventilator and the second with an extubation without disconnection of the respiratory positive pressure<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Desaturation rate | defined by a SpO2 < 92% | within one hour of tracheal extubation |