Observation of B-lines in Pulmonary Echography, During Open Abdominal Surgery

Study Overview
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Brief Summary
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There is no a reliable marker of intraoperative fluid excess or overload. The use of lung ultrasound in other settings, such as emergency room and critical care patients, helps us to determine if a patient has a condition of augmented intrathoracic fluid, that could be related to several circumstances, such as fluid overload, but also to heart failure, in example. Nevertheless, there is no information regarding the basal incidence of this finding, to ascertain if could be eventually used as a potential marker of fluid overload. This protocol looks for the incidence of the finding of B-Lines, which are related to fluid overload, in patients undergoing open abdominal surgery.

Detailed Description
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The presence of B-lines will be observed in 4 spaces at each evaluation: Anterior-superior, and infero-lateral, by each side. The times of evaluation will be prior to intubation, after intubation, every one hour of surgery, at the end of the surgery prior to extubation, and after 2 hours in the postoperative care unit. Other variables addressed will be the vital signs, parameters related to a diminished intravascular status (ie, pulse pressure variability), central venous pressure, volume changes (reposition, bleeding, diuresis), and requirements of blood products. A correlation with baseline characteristics of patients will be observed; nevertheless, this study is directed as primary endpoint to evaluate the incidence of the B-lines in echography, and the sample size was calculated following this endpoint.

Official Title
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Incidence of B-Lines in Pulmonary Echography, in Patients Undergoing Open Abdominal Surgery.

Conditions
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Open Abdominal Surgery, Lung Ultrasound

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients scheduled to open abdominal surgery Older than 18 years. Exclusion Criteria: Previous thoracic surgery, BMI over 30 kg/m2 Baseline respiratory alterations related to preoperative supplementary oxygen requirements Evident malformations of the thoracic wall If the position required for the surgery does not allow the echographic windows required for the protocol

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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients undergoing open abdominal surgery<br>Patients older than 18 years undergoing open abdominal surgery. They will be followed by a protocol of pulmonary echography during and after surgery in the postoperative care unit | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Apparition of pulmonary B-Lines | 3 or more B-Lines in any evaluated quadrant | During surgery and after 2 hours in the postoperative care unit | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pulmonary complications | Requirements of supplementary oxygen at PACU discharge or postoperative mechanical ventilatory support | After 2 hours in the postoperative care unit | 
| fluid administration and B lines | Correlation of fluid administration and appearance of B lines | During surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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lung ultrasound, B-Lines