Clinical trial NCT03830099: Inhomogeneous Ventilation in Adult Post-neurosurgical Patients
Official title: Inhomogeneous Ventilation in Adult Post-neurosurgical Patients: an Observational Study
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Mechanical Ventilation
Electrical Impedance Tomography
Inhomogeneous Ventilation
Neurosurgery
Lead sponsor: Capital Medical University
Sponsor class: OTHER
First posted: 2019-02-05
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: OTHER
Sampling method: PROBABILITY_SAMPLE
Study population: Adult post-neurosurgical patients under mechanical ventilation(MV).

Brief summary: Inhomogeneous ventilation was more likely to happen in patients after general anesthesia. Inhomogeneous ventilation may associate with ventilator-induced lung injury. A large number of post-neurosurgical patients was delayed extubation and received mechanical ventilation, so that, inhomogeneous ventilation was more likely to happen in the population. Electrical impedance tomography (EIT) is an noninvasive, radiation-free, high temporal resolution, relatively cheap technique in monitoring ventilation distribution bedside. The investigators aimed to investigate the incidence of inhomogeneous ventilation and factors associated with inhomogeneous ventilation in post-neurosurgical patients under mechanical ventilation.

Detailed description: Inhomogeneous ventilation was more likely to happen in patients after general anesthesia. Inhomogeneous ventilation may associate with ventilator-induced lung injury since the gravity-depend collapse and over-distention of nondependent regional in patients under mechanical ventilation. A large number of post-neurosurgical patients was delayed extubation and received mechanical ventilation, so that, inhomogeneous ventilation was more likely to happen in the population. Up to now, there is no research reported about the prevalence of inhomogeneous ventilation and the factors associated with inhomogeneous ventilation in post-neurosurgical patients, in present study, The investigators prospectively enrolled adult patients after neurosurgical operations. Electrical impedance tomography (EIT) is an noninvasive, radiation-free, high temporal resolution, relatively cheap technique in monitoring ventilation distribution bedside. The investigators aimed to investigate the incidence of inhomogeneous ventilation and factors associated with inhomogeneous ventilation in post-neurosurgical patients under mechanical ventilation.

Eligibility criteria: Inclusion Criteria:

* Undergoing elective neurosurgery operation
* Trachea intubated and mechanical ventilated

Exclusion Criteria:

* Age under 18 years-old
* Unstable hemodynamics patients (mean arterial pressure under 65mmHg) after pharmacotherapy
* History of chronic obstructive pulmonary disease(COPD) or asthma
* Contraindication of using EIT (pacemaker, defibrillator, and implantable pumps)
* Unable to install EIT belt (skin infection, wound)
* Incompleteness of thorax (e.g. pneumothorax, rib fracture and etc.) or malformation of thorax.

Primary outcomes:
measure: Incidence of inhomogeneous ventilation
timeFrame: within 24 hours after neurosurgical operative
Secondary outcomes:
measure: The incidence of postoperative pulmonary complications(PPCs)
timeFrame: 28 days after neurosurgical operative
measure: Length of ICU stay
timeFrame: through study completion, an average of 7 days
measure: Length of hospital stay
timeFrame: through study completion, an average of 28 days
Other outcomes:
Locations:
city: Beijing
country: China
facility: ICU, Beijing Tiantan Hospital, Capital Medical University
state: Beijing
Study officials:
affiliation: Beijing Tiantan Hospital
name: Jian-Xin Zhou, MD
role: PRINCIPAL_INVESTIGATOR
References: