Hemodynamic Effects of Ventilation Modes

Study Overview
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Brief Summary
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Different ventilation modes can be used in laparoscopic surgeries. These surgeries are performed in steep Trendelenburg position with serious hemodynamic disturbances. This study aims to observe the hemodynamic effects of two different ventilation modes in laparoscopic gynecologic surgery performed in steep Trendelenburg position.

Official Title
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Effects of Two Different Ventilation Modes Used in Gynecologic Laparoscopic Operations Performed in Steep Trendelenburg Position on Hemodynamic Parameters

Conditions
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Hemodynamics, Respiration, Artificial, Laparoscopy

Intervention / Treatment
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* Procedure: Mode of Mechanical Ventilation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women of ASA I and II classification between 18-65 years scheduled for elective gynecologic laparoscopic surgery Exclusion Criteria: Patient refusal to participate Patients with severe cardiac (congestive heart failure etc) and pulmonary (COPD, pulmonary hypertension) disease (ASA > III) Morbid obesity Negative Allen test

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group V<br>The patients in this group are ventilated using VCV (Volume Control Ventilation) mode (FiO2 50%, Tidal volume: 6-8 ml/kg (ideal body weight), frequency: 12/minute, I/E ratio: 1/2, PEEP not applied) | Procedure: Mode of Mechanical Ventilation<br>* Adjustment of mechanical ventilation mode<br>|
| Group P<br>The patients in this group are ventilated using PCV-VG (Volume Guaranteed Pressure Control Ventilation) mode (FiO2 50%, Tidal volume: 6-8 ml/kg (ideal body weight), frequency: 12/minute (EtCO2 kept between 35-40 mmHg), Pressure limit: 30 cm H2O, I/E:1/2, PEEP not applied) | Procedure: Mode of Mechanical Ventilation<br>* Adjustment of mechanical ventilation mode<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of changes in MAP | Mean arterial pressure (MAP) (mmHg) | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 
| Measurement of changes in heart rate | Heart rate (bpm) | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 
| Measurement of changes in systemic vascular resistance index | Systemic vascular resistance index (dyne x sec/cm2) | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 
| Measurement of changes in stroke volume index | Stroke volume index (mL/m2) | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 
| Measurement of changes in cardiac index | Cardiac index L(min x m2) | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 
| Measurement of changes in stroke volume variation | Stroke volume variation (%) | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 
| Measurement of changes in cardiac cycle efficiency | Cardiac cycle efficiency (units) | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 
| Measurement of changes in aortic dp/dt | Aortic dP/dt (mmHg/msec) | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of changes in peak airway pressure | Ppeak (Peak airway pressure) | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 
| Measurement of changes in mean airway pressure | Pmean (Mean Airway Pressure), | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 
| Measurement of changes in plateau airway pressure | Pplateau (Plateau Airway Pressure) | T0: Induction (Baseline) T1: Change after 30 minutes pneumoperitoneum T2: Change after desufflation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mechanical ventilation, Laparoscopic surgery, Hemodynamics