Mode of Ventilation and Bleeding During Transsphenoidal Surgery (Vent-Hyp)
Transsphenoidal Surgery for Pituitary Adenomas: Influence of the Ventilation Mode on Intraoperative Bleeding
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The risk of bleeding is important during transsphenoidal surgery. This study aims to find if the ventilation mode, controlled pressure and controlled volume, modifies the risk of bleeding.
- group Volume controlled ventilation: tidal volume of 7 mL/kg ideal body weight, frequency of 12 cycles/minute, I/E ratio of 1:2, no positive end expiratory pressure. Ventilatory frequency is changed if necessary to maintain end-expiratory pressure of CO2 between 35 and 40 mmHg.
- group Pressure-controlled ventilation: initial pressure of 15 cm H2O, frequency of 12 cycles/minute, I/E ratio of 1:2, no positive end expiratory pressure. Pressure is modified to maintain a tidal volume of 7 mL/kg of ideal body weight and frequency ventilation is modified to maintain end-expiratory pressure of CO2 between 35 and 40 mmHg.
- In both groups, the fraction of inspired oxygen is 50%. A recruitment maneuver is performed if the blood oxygen saturation became less than 92%.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Suresnes, France, 92150
- Hôpital Foch
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Aged > 18 years
- Patients scheduled for transsphenoidal surgery for pituitary adenomas
Exclusion Criteria:
- Pregnancy
- Obesity (BMI> 35)
- Known respiratory disease
- Redo surgery
- Preoperative problem with hemostasis (antiplatelet or anticoagulant treatment; constitutional disorder).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Volume controlled ventilation
Volume controlled ventilation: tidal volume of 7 mL/kg ideal body weight, frequency of 12 cycles/minute, I/E ratio of 1:2, no positive end expiratory pressure.
Ventilatory frequency is changed if necessary to maintain end-expiratory pressure of CO2 between 35 and 40 mmHg.
|
|
|
Experimental: Pressure-controlled ventilation
initial pressure of 15 cm H2O, frequency of 12 cycles/minute, I/E ratio of 1:2, no positive end expiratory pressure.
Pressure is modified to maintain a tidal volume of 7 mL/kg of ideal body weight and frequency ventilation is modified to maintain end-expiratory pressure of CO2 between 35 and 40 mmHg
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
intraoperative bleeding
Time Frame: 1 hour postoperatively
|
intraoperative bleeding is estimated by the operator (always the same) as minimal (1), low (3), with no significant change in the conduct of the surgical procedure (5) with significant change in the conduct of surgical procedure (7).
Intermediate levels are used to rate the levels of intermediate severity.
|
1 hour postoperatively
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
generated plateau pressures
Time Frame: one hour after surgery
|
mean ventilatory plateau pressure during surgery
|
one hour after surgery
|
|
realisation of predefined objectives of minute ventilation
Time Frame: one hour after surgery
|
time spent with the predefined objectives of minute ventilation
|
one hour after surgery
|
|
changes of ventilation mode
Time Frame: one hour after surgery
|
number of changes of ventilation mode
|
one hour after surgery
|
|
arterial desaturation
Time Frame: one hour after surgery
|
number of episodes of arterial desaturation (SpO2 <92%) and lower arterial saturation during surgery
|
one hour after surgery
|
|
recruitment maneuver
Time Frame: one hour after surgery
|
number of recruitment maneuver
|
one hour after surgery
|
|
duration of the surgical procedure
Time Frame: one hour after surgery
|
duration from surgical incision to end of the surgical procedure
|
one hour after surgery
|
|
endocrine healing
Time Frame: three months after surgery
|
return to a low level of the abnormal endocrin abnormalities
|
three months after surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2012/15
- 2012-A00397-36 (Other Identifier: ANSM)
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