Ultrasound Evaluation of Preventive Measures for Postoperative Lung Atelectasis After Surgery (LUS/PEEP/RM)

Ultrasound Evaluation of Different Preventive Measures of Post Operative Lung Atelectasis After Upper Abdominal Surgeries: Ventilation and Fluid Measures

the aim of this prospective randomized blinded clinical study will be to assess the ultrasound evaluation of different preventive measures of post operative lung atelectasis in abdominal surgeries; these measures include ventilation and fluid measures

Study Overview

• Status: Completed
• Conditions: Pulmonary Atelectasis, Postoperative
• Intervention / Treatment: Other: PEEP; Other: PEEP/RM; Other: PEEP/RM/RF

Detailed Description

ultrasound evaluation for application of different preventive measures of post operative lung atelectasis, including positive end-expiratory pressure, lung recruitment maneuvers, and restrictive fluid management.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Asyut, Egypt
    • Al-Azhar University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• ASA physical status I or II, of either gender.
• BMI < 40
• Age 30-60 years
• scheduled for elective abdominal surgeries

Exclusion Criteria:

• Patient refusal
• American Society of Anesthesiologists (ASA) physical status classification system more than II
• BMI > 40 .
• Psychiatric disorders
• History of chest disorders such as asthma and obstructive pulmonary disease (COPD).
• History of Previous Thoracic Procedures.
• Pregnancy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group I: PEEP; Patients will be ventilated with PEEP of 8 cm H2O and fluid management: 500 ml of Ringer's lactate in the recovery room before surgery and Ringer's lactate at a rate of 4 mL/kg/hour from the beginning to the end of the surgery.	Other: PEEP; Patients will be ventilated with PEEP of 8 cm H2O and fluid management: 500 ml of Ringer's lactate in the recovery room before surgery and Ringer's lactate at a rate of 4 mL/kg/hour from the beginning to the end of the surgery.
Experimental: Group II: PEEP/RM; Patients will be ventilated with PEEP of 8 cm H2O, and then RM (30 cm H2O for 30 s) will be applied immediately after the second LUS examination and repeated every 30 minutes till emergence and fluid management: 500 ml of Ringer's lactate in recovery room before surgery and Ringer's lactate at a rate of 4 mL/kg/hour from the beginning to the end of the surgery	Other: PEEP/RM; Patients will be ventilated with PEEP of 8 cm H2O, and then RM (30 cm H2O for 30 s) will be applied immediately after the second LUS examination and repeated every 30 minutes till emergence and fluid management: 500 ml of Ringer's lactate in recovery room before surgery and Ringer's lactate at a rate of 4 mL/kg/hour from the beginning to the end of the surgery
Experimental: Group III: PEEP/RM/RF; Patients will be ventilated with PEEP of 8 cm H2O, and then RM (30 cm H2O for 30 s) will be applied immediately after the second LUS examination and repeated every 30 minutes till emergence and restrictive fluid management (RF). Ringer's lactate at a rate of 3 mL/kg/hour from the beginning to the end of the surgery	Other: PEEP/RM/RF; Patients will be ventilated with PEEP of 8 cm H2O, and then RM (30 cm H2O for 30 s) will be applied immediately after the second LUS examination and repeated every 30 minutes till emergence and restrictive fluid management (RF). Ringer's lactate at a rate of 3 mL/kg/hour from the beginning to the end of the surgery

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lung ultrasound assessment of postoperative pulmonary atelectasis at the end of surgery	Lung ultrasound assessment of postoperative pulmonary atelectasis at the end of surgery. The Lung Ultrasound Score (LUS): the key points based on ultrasound findings: I. 0 points: (N) Normal aeration (presence of lung sliding with A-lines or <2 separate B-lines). II. 1 point: (B1) Moderate loss of lung aeration (≥3 well-defined B lines). III. 2 points: (B2) Severe loss of lung aeration (coalescing B-lines). IV. 3 points: (C) Complete loss of lung aeration (pulmonary consolidations). Total Score: points will be distributed according to the worst ultrasound pattern observed: N = 0, B1 lines = 1, B2 lines = 2, C = 3. The LUS score ranging between 0 and 36 was calculated as the sum of points.	at the end of surgery before emergence from GA.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lung ultrasound assessment	Lung ultrasound assessment of atelectasis	before induction of general anesthesia
Lung ultrasound assessment	Lung ultrasound assessment of atelectasis	5 minutes post induction of general anesthesia
Lung ultrasound assessment	Lung ultrasound assessment of atelectasis	15 minutes after patients arrive to PACU
Lung ultrasound assessment	Lung ultrasound assessment of atelectasis	60 minutes after patients arrive to PACU
arterial blood gases	Pao2, spo2, paco2, pao2/fio2	5 minutes post induction of general anesthesia
arterial blood gases	Pao2, spo2, paco2, pao2/fio2	before emergence from general anesthesia
arterial blood gases	Pao2, spo2, paco2, pao2/fio2	15 minutes after patients arrive to PACU

Collaborators and Investigators

• Sponsor: Al-Azhar University
• Investigators: Principal Investigator: Hamed M Wally Allah, Al-Azhar University

Study record dates

Study Major Dates

• Study Start (Actual): December 8, 2024
• Primary Completion (Actual): December 19, 2025
• Study Completion (Actual): December 19, 2025

Study Registration Dates

• First Submitted: October 20, 2024
• First Submitted That Met QC Criteria: October 21, 2024
• First Posted (Actual): October 23, 2024

Study Record Updates

• Last Update Posted (Actual): December 26, 2025
• Last Update Submitted That Met QC Criteria: December 19, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: lung ultrasound; Atelectasis; lung recruitment maneuver; Pulmonary Atelectasis; lung Atelectasis; pressure controlled ventilation - volume guarantee (PCV- VG); positive end-expiratory pressure (PEEP); restrictive fluid strategies
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Lung Diseases; Pulmonary Atelectasis
• Other Study ID Numbers: AZAST/MD/209/MARCH/2024

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No