Clinical trial NCT03486847: Postoperative Atelectasis in Pediatric Patients With Prone Position
Official title: Postoperative Atelectasis in Pediatric Patients With Prone Position : Effect of Repetitive Alveolar Recruitment by Lung Ultrasound
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Pulmonary Atelectasis, Postoperative
Atelectasis, Compression
Lead sponsor: Seoul National University Hospital
Sponsor class: OTHER
First posted: 2018-04-03
Enrollment: 74
Sex: ALL
Maximum age (years): 3
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: This study evaluates the incidence of postoperative atelectasis after general anesthesia with prone position using lung ultrasound in children age \< 3 years.

Detailed description: Atelectasis is common in pediatric patients after general anesthesia. Particularly, infants are more likely to develop atelectasis or ventilation-perfusion imbalance after general anesthesia because of the immature ribs and respiratory muscles, the high compliance of the rib cage and a significant reduction in functional residual capacity (FRC) during general anesthesia. Previous studies have reported that alveolar recruitment and positive end-expiratory pressure (PEEP) can be used to reduce atelectasis in children. Also, previous studies have shown that the lung ultrasound can be used to evaluate the degree of atelectasis during general anesthesia in children.

However, none of the previous studies investigated the incidence of atelectasis, the effect of alveolar recruitment, and the PEEP in pediatric patients under general anesthesia with prone position. The purpose of this study was to evaluate previously described parameters using lung ultrasound.

Eligibility criteria: Inclusion Criteria:

* Children undergoing general anesthesia with prone position
* Endotracheal intubation and mechanical ventilation during general anesthesia
* Operation time is more than 2 hours

Exclusion Criteria:

* Previous lung surgery
* Any abnormal findings such as atelectasis, pneumothorax, pleural effusion, or pneumonia on preoperative chest X-ray
* Researchers judge (to be inappropriate)

Primary outcomes:
measure: Incidence of pre-extubation atelectasis
timeFrame: postoperative 10 minutes
Secondary outcomes:
measure: Incidence of intraoperative atelectasis after intubation
timeFrame: intraoperative
measure: Incidence of intraoperative atelectasis after position change to prone
timeFrame: intraoperative
measure: Incidence of intraoperative and postoperative (within 12hr) desaturation
timeFrame: intraoperative and postoperative (within 12hr)
measure: Incidence of intraoperative hypotension
timeFrame: intraoperative
Other outcomes:
Locations:
city: Seoul
country: Korea, Republic of
facility: SNUH
state: Jongnogu
Study officials:
affiliation: Seoul National University Hospital
name: Hee Kim, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Jang YE, Ji SH, Kim EH, Lee JH, Kim JT, Kim HS. Effect of regular alveolar recruitment on intraoperative atelectasis in paediatric patients ventilated in the prone position: a randomised controlled trial. Br J Anaesth. 2020 May;124(5):648-655. doi: 10.1016/j.bja.2020.01.022. Epub 2020 Mar 10.