Clinical trial NCT06221449: Lung Recruitment in Laparoscpic Surgery
Official title: Effect of Lung Recruitment on Atelectasis in Lung-Healthy Patients Undergoing Laparoscopic Cholecystectomy
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Atelectasis, Postoperative
Keywords: laparoscopic, atelectasis, recruitment maneuver,
Lead sponsor: Menoufia University
Sponsor class: OTHER
First posted: 2024-01-24
Enrollment: 93
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: SEQUENTIAL
Intervention model description: comparison
Primary purpose: PREVENTION

Brief summary: The goal of this clinical trial study is to assess the effectiveness of different methods of lung recruitment maneuver on the incidence of atelectasis in adults undergoing laparoscopic cholecystectomy surgery using lung ultrasound Participants will be divided into three groups as: Control group, sustained inflation group (SI) and Stepwise Positive end expiratory pressure increasing group(Third group). Each contains 31 patients.

Control Group = Keep parameters all through the procedure without any changing GROUP(SI) = After abdominal deflation, we will apply sustained inflation by adjusting Adjustible pressure Limiting valve 40 centimetres water on spontaneous mode, holding the bag for 30 second.

Third group = After abdominal deflation, we will apply stepwise Positive Pressure increasing by 2 centimetres water every 5 breathing cycles till reaching 12 centimetres water and keeping it till extubation, with a maximum airway pressure not exceeding 40 centimetres water.

Detailed description: the effectiveness of different methods of lung recruitment maneuver on the incidence of atelectasis in adults undergoing laparoscopic cholecystectomy surgery using lung ultrasound Participants will be divided into three groups as: Control group, sustained inflation group (SI) and Stepwise POSITIVE pressure increasing group. Each contains 31 patients.

Control Group = Keep parameters all through the procedure without any changing GROUP(SI) = After abdominal deflation, The investigators will apply sustained inflation by adjusting Adjustible pressure valve 40 centimetres water spontaneous mode, holding the bag for 30 second.

Third group = After abdominal deflation, the investigators will apply stepwise POSITIVE pressure increasing by 2 centimeters water 5 breathing cycles till reaching 12 centimetres water and keeping it till extubation, with a maximum airway pressure not exceeding 40 centimetreswater.

During the entire procedure the transducer head will be placed over one point of the chest selected by the operator where the area of atelectasis was detected The probe will be placed in the atelectasis area.

Eligibility criteria: Inclusion Criteria:

* Patients with healthy lungs

  * Age between 18 and 65 years old
  * Body mass index (BMI) \<30 kg / m2
  * Physical status I-II of the American Society of Anesthesiologists (ASA)
  * Elective laparoscopic cholecystectomy.

Exclusion Criteria:

* Patient refusal
* Patients with preoperative ultrasound evidence of pulmonary atelectasis.
* Patients who will have conversion from laparoscopic to open surgery.
* Patients experiencing critical postoperative complications such as severe subcutaneous emphysema and pneumothorax.
* Patients with pulmonary, cardiac, and neuromuscular diseases and a corresponding surgical history and respiratory tract infections.

Primary outcomes:
measure: Incidence of atelectasis
timeFrame: one hour
Secondary outcomes:
measure: Lung ultrasound score
timeFrame: one day
measure: Blood pressure ( millimetre Mercury)
timeFrame: Two hour
measure: Heart rate
timeFrame: Two hour
measure: Hospital length of stay
timeFrame: One day
Other outcomes:
Locations:
city: Shibīn Al Kawm
country: Egypt
facility: Menoufia University
Study officials:
References: