The Effects of Two Different Ventilation Strategies on Lung Ventilation: An Ultrasonographic Evaluation.

Study Overview
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Brief Summary
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This study will be performed in robotic assisted laparoscopic radical prostatectomy patients in Cerrahpasa Medical Faculty Monoblock Operating Room. Since robot-assisted laparoscopic radical prostatectomy is a surgical procedure which requires long-term mechanical ventilation, excessive trendelenburg position (30-45 °) and pneumoperitoneum; these interventions may lead to respiratory complications such as ventilation difficulty and aeration loss in patients. Nowadays, lung ultrasonography has been used in anesthesia practice and intensive care units in order to determine lung aeration loss. In this study, the investigators aimed to compare the possible aeration loss in lung parenchyma during pressure controlled ventilation and volume controlled ventilation which are frequently used in anesthesia practice in patients undergoing robotic radical prostatectomy.

Official Title
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The Effects of Two Different Ventilation Strategies on Lung Ventilation in Patients Undergoing Robotic Radical Prostatectomy: Ultrasonographic Evaluation.

Conditions
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Prostate Cancer

Intervention / Treatment
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* Other: Pressure Controlled Ventilation
* Other: Volume Controlled Ventilation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18-75 age Patient who will be undergo robot assisted laparoscopic prostatectomy surgery Patient with ASA (American Society of Anesthesiologists) Score 1-3 Exclusion Criteria: Patients with ASA Score above 3 Patients with obstructive (FEV1<%60) or restrictive pulmonary disease (FVC<%60) Patients with intrathoracic operation history Heavy smokers (>25 cigarettes/day)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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Male

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: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Pressure Controlled Ventilation<br>Patients undergoing pressure controlled ventilation | Other: Pressure Controlled Ventilation<br>* Patients will be ventilated with a pressure level which supplies a tidal volume corresponding 8ml/kg, 12 breaths per minute, 1/2 inspiration/expiration ratio and %40 Fraction of Inspired Oxygen . These ventilator settings can be changed in order to adjust end tidal carbon dioxide and oxygen saturation levels.<br>|
| Active Comparator: Volume Controlled Ventilation<br>Patients undergoing volume controlled ventilation | Other: Volume Controlled Ventilation<br>* Patients will be ventilated with a tidal volume which corresponds 8ml/kg, 12 breaths per minute, 1/2 inspirastion/expiration ratio and %40 Fraction of Inspired Oxygen . These ventilator settings can be changed in order to adjust end tidal carbon dioxide and oxygen saturation levels.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The difference between LUS Scores at T5 in patients ventilated with VCV and PCV | Lung Ultrasonography will be applied to patients after surgery in the recovery room at T5. Two different groups' LUS scores will be calculated and compared. | (T5) 60 minutes after patients come to the recovery room. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The difference between LUS Scores at T2 in patients ventilated with VCV and PCV | Lung Ultrasonography will be applied to patients after intubation. Two different groups' LUS scores will be calculated and compared. | (T2) 5 minutes after intubation | 
| The difference between LUS Scores at T3 in patients ventilated with VCV and PCV | Lung Ultrasonography will be applied to patients at Trendelenburg position after the surgical prosedure is finished. Two different groups' LUS scores will be calculated and compared. | (T3) 5 minutes after the surgical procedure is finished | 
| The difference between LUS Scores at T4 in patients ventilated with VCV and PCV | Lung Ultrasonography will be applied to patients at supin position after the surgical prosedure is finished. Two different groups' LUS scores will be calculated and compared. | (T4) 5 minutes after taking the patient to supin position | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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lung ultrasonography, mechanical ventilation, pressure controlled ventilation, volume controlled ventilation