Clinical trial NCT05720351: Alveolar Recruitment Maneuvers on Reduction of Lung Atelectasis in Bariatric Surgery by Using Lung Ultrasound Score
Official title: Comparison Between Two Alveolar Recruitment Maneuvers on Reduction of Lung Atelectasis in Bariatric Surgery by Using Lung Ultrasound Score
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Alveolar Recruitment Maneuvers
Atelectasis
Bariatric Surgery
Lead sponsor: Tanta University
Sponsor class: OTHER
First posted: 2023-02-09
Enrollment: 50
Sex: ALL
Minimum age (years): 21
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: DIAGNOSTIC

Brief summary: The study aims to compare the staircase alveolar recruitment maneuver with PEEP titration versus sustained inflation alveolar recruitment maneuver by using lung ultrasound score as an indicator of improving lung atelectasis in bariatric surgery

Detailed description: Weight loss surgery, often known as bariatric surgery, is an effective obesity treatment. Most people undergoing such surgery may show an improvement in, or the resolution of, conditions such as diabetes, dyslipidemia, hypertension, and obstructive sleep apnea.

Currently, there is no standard ventilation strategy has been established for obese patients. However, there is some evidence that recruitment maneuvers (RM) combined with protective lung ventilation strategy improve oxygenation and compliance compared to other strategies.

Alveolar recruitment maneuver refers to the periodic hyperinflation of the lungs that has been utilized to open up the lung and keep the lung open in anesthetized patients. The use of recruitment maneuvers has been shown to reduce the incidence and extent of atelectasis during general anesthesia by different methods.

Lung ultrasonography is considered a useful tool in perioperative care. Recent research showed that lung ultrasound could assess lung aeration and diagnose anesthesia-induced atelectasis accurately in the perioperative period by measuring the extent of atelectasis by the scoring system; also, the response to recruitment manoeuver for each patient can be evaluated easily. Thus, it has great potential as a bedside non-invasive, sensitive tool for guiding effective recruitment manoeuvers to reduce the formation of pulmonary atelectasis in the surgical setting

Eligibility criteria: Inclusion Criteria:

* Adult morbidly obese patients (Body mass index \< 40kg / m2 or Body mass index \< 35kg / m2 with obesity-related comorbidities such as hypertension, diabetes, and sleep apnea)
* undergo elective bariatric laparoscopic surgery with an expected duration of at least one hour under general anesthesia.

Exclusion Criteria:

* Patient refusal to participate in the study.
* Patients with a previous history of thoracic surgery.
* Patients with a history of chest disease (COPD, emphysema, or pneumothorax).
* Patients with abnormal pre-operative chest radiographs such as pneumonia, pleural effusion.
* Patients with heart failure or impending failure.
* Patients with known hypovolemia.
* Patients with increased intracranial pressure.

Primary outcomes:
measure: Improvement of Lung ultrasound score.
timeFrame: 48 hours postoperatively
Secondary outcomes:
measure: Access Pulmonary complications
timeFrame: 48 hours postoperatively
measure: Access incidence of oxygen desaturation
timeFrame: 48 hours Postoperatively
measure: Access Complications of recruitment maneuver
timeFrame: 48 hours Postoperatively
Other outcomes:
Locations:
city: Tanta
country: Egypt
facility: Alaa Mohsen Shahien
state: ElGharbiaa
Study officials:
References: