Ultrasound for Postop Lung Issues in Low-Flow Anesthesia

Evaluation of Early Postoperative Pulmonary Complications That Can be Detected by Ultrasonography in Patients Undergoing Laparoscopic Cholecystectomy With Low-flow Anesthesia

Detecting possible atelectasis and other respiratory problems that may develop immediately after extubation via lung ultrasonography can reduce pulmonary complications by performing necessary interventions such as oxygen support, respiratory exercises, mobilization, and non-invasive mechanical ventilation applications at an early stage. In addition, although low-flow anesthesia is frequently used in daily anesthesia practice, publications showing the effects of its use in laparoscopic cholecystectomy operations on pulmonary complications are limited. On this occasion, this study can be presented as a contribution to the literature.

Study Overview

• Status: Recruiting
• Conditions: Pulmonary Atelectasis; Cholecystitis; Gallstone; Atelectasis, Postoperative
• Intervention / Treatment: Other: No-intervention

Detailed Description

Postoperative atelectasis is a common complication that can develop in all patients receiving general anesthesia. The frequency of atelectasis increases due to increased intraabdominal pressure, especially in laparoscopic surgeries performed with pneumoperitoneum. For this reason, in order to prevent postoperative complications related to the lungs, it is extremely important to recognize atelectasis at an early stage, as well as to recognize the mechanisms that will cause atelectasis and avoid them.

Lung ultrasonography (Lung USG) draws attention for the rapid, cheap, safe and reliable detection of postoperative atelectasis. The fact that it can be applied at the bedside and can be easily repeated makes this method valuable. In the literature and in daily practice, it is seen that anesthesiologists commonly apply inhalation anesthesia with different fresh gas flow (FGF) rates during general anesthesia.

As defined by Baker and Simionescu, in low-flow anesthesia, FGF varies between 0.5 and 1 liter per minute. It has been shown that all types of flow are safe with modern anesthesia machines.

This study aims to demonstrate the effect of low-flow anesthesia (LFA) on pulmonary complications and, in particular, atelectasis that may develop after laparoscopic cholecystectomy operations, using a non-invasive, rapidly applicable, and proven method such as Lung USG.

• Study Type: Observational
• Enrollment (Estimated): 110

Contacts and Locations

• Study Contact: Name: Hilal SAZAK, MD; Phone Number: +90 312 356 90 00; Email: hilalgun@yahoo.com
• Study Contact Backup: Name: Necla DERELI, MD

Study Locations

• Turkey (Türkiye)
  • Ankara, Turkey (Türkiye)
    • Recruiting
    • Ankara Ataturk Sanatorium Research and Training Hospital
    • Contact: Mustafa Ozgur CIRIK, Assoc. Prof.; Phone Number: 2031 90 312 567 70 00; Email: dr.ozgurr@outlook.com

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

All cases that meet the inclusion and exclusion criteria will be included in the study. Patients will be taken to the operating room after being preoperatively evaluated in the observation room. The patient's anesthetic management will be provided by another anesthesiologist who is not participating in the study and is responsible for the patient. Intraoperative data will be obtained from the patient's anesthesia follow-up form and the records of the anesthesia machine. When the patients arrive in the recovery room, postoperative ultrasonographic measurements and other evaluations will be performed and noted. This group will include patients who received general anesthesia using low-flow techniques during the intraoperative period.

Description

Inclusion Criteria:

• Patients with informed consent
• Patients scheduled for laparoscopic cholecystectomy
• Patients with a Body Mass Index between 18-35 kg/m²
• Patients in the American Society of Anesthesiologist (ASA) 1-2-3 category

Exclusion Criteria:

• Patients with emergency surgery planned
• Patients with ASA 4 and above
• Patients with lung disease
• Patients who have undergone thoracic surgery
• Pregnancy
• Patients with a preoperative Lung Ultrasound Score of 2 or 3 in any lung region

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Low-Flow Anesthesia Group; As this study is observational in nature, no interventions will be performed by the research team. The study will involve a single group, within which the incidence and prevalence of the outcomes will be assessed.	Other: No-intervention; No interventions will be performed by the research team.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
incidence of postoperative atelectasis	Incidence of postoperative atelectasis determined by lung ultrasonography in patients undergoing laparoscopic cholecystectomy with low-flow anesthesia	1 hour peroperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
incidence of other postoperative pulmonary complications	Other postoperative pulmonary complications that may develop and be detected by ultrasonography such as pneumothorax, pleural effusion, pulmonary edema	1 hour peroperatively

Collaborators and Investigators

• Sponsor: Ankara Ataturk Sanatorium Training and Research Hospital
• Investigators: Principal Investigator: Mustafa Özgür CIRIK, MD, Ankara Ataturk Sanatorium Training and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): February 15, 2025
• Primary Completion (Actual): March 31, 2025
• Study Completion (Estimated): June 15, 2026

Study Registration Dates

• First Submitted: February 6, 2025
• First Submitted That Met QC Criteria: February 11, 2025
• First Posted (Actual): February 13, 2025

Study Record Updates

• Last Update Posted (Actual): June 5, 2026
• Last Update Submitted That Met QC Criteria: June 4, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: lung ultrasound; laparoscopic cholecystectomy; low flow anesthesia
• Additional Relevant MeSH Terms: Calculi; Pathological Conditions, Anatomical; Respiratory Tract Diseases; Digestive System Diseases; Lung Diseases; Biliary Tract Diseases; Gallbladder Diseases; Cholelithiasis; Cholecystolithiasis; Pathological Conditions, Signs and Symptoms; Pulmonary Atelectasis; Cholecystitis; Gallstones
• Other Study ID Numbers: SanatoryumEAH-AK-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No