THE EFFECT OF ALVEOLAR RECRUITMENT MANOEUVRE ON INTRAOPERATIVE HAEMODYNAMICS

Alveolar recruitment manoeuvre plays a key role in the prevention of atelectasis. In addition, it affects haemodynamic parameters. This study aims to investigate the effects of RM on haemodynamic parameters using minimally invasive monitoring techniques.

Study Overview

• Status: Completed
• Conditions: Laparoscopic Hysterectomy; ASA Class I/II Patients Scheduled for Surgery Under General Anesthesia

Detailed Description

During laparoscopic hysterectomy, pneumoperitoneum is created with carbon dioxide (CO₂) to provide surgical field of view and the patient is placed in Trendelenburg position. This increases intrathoracic pressure, decreases lung compliance and increases the risk of atelectasis. Therefore, lung protective ventilation strategies such as alveolar recruitment manoeuvre (RM), individualised PEEP application and low tidal volume are recommended. RM aims to increase lung compliance and prevent atelectasis by reopening collapsed alveoli. However, changes in haemodynamic parameters, especially mean arterial pressure and cardiac output, may occur during RM. In addition to standard monitoring for the management of these changes, haemodynamic evaluation can be performed with minimally invasive methods such as arterial waveform analysis. In this study, we aimed to evaluate the effects of RM applied during laparoscopic hysterectomy on intraoperative haemodynamic parameters using arterial waveform analysis.

• Study Type: Observational
• Enrollment (Actual): 70

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Balıkesir, Turkey (Türkiye), 10145
    • Balikesir University

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Probability Sample

Study Population

• ASA I-II risk group patients
• Patients between 18-70 y undergoing laparoscopic hysterectomy surgery

Description

Inclusion Criteria:

• ASA Class 1-2 patients 18-70 years old

Exclusion Criteria:

• <18 y, BMI>40
• Patients receiving invasive mechanical ventilator support in the last 1 month
• Patients who have received chemotherapy or radiotherapy in the last 2 months
• Those with severe lung disease (COPD, asthma, pulmonary infection, bronchiectasis, previous need for non-invasive mechanical ventilation, oxygen therapy or steroid therapy for acute attack)
• Known severe pulmonary hypertension
• Patient refusal to participate in the study
• Intracranial tumour
• Haemodynamic instability
• Shock
• Neuromuscular disease
• Pathologies causing increased intracranial and intraocular pressure
• Atrial fibrillation

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Alveolar Recruitment Maneuver Applied
Alveolar Recruitment Maneuver Not Applied

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Effect of RM on heart rate (in bpm)	measurement of heart rate in bpm	perioperatively
Effect of RM on pressure mmHg	blood pressure measurement in mmmercury	perioperatively
Effect of RM on Cardiac index(CI)	Cardiac Index measurement via an arterial cannula as l/min/m2	intraoperatively
Effect of RM on stroke volume index(SVI)	SVI measurement via arterial cannula as L/min/m2	intraoperatively
Effect of RM on pulse pressure variablity(PPV)	pulse pressure variability measured by finger probe as cm/s	intraoperatively
Effect of RM on systemic vascular resistance index(SVRI)	systemic vascular resistance index(SVRI) measurement via arterial cannula as L/min/m2	intraoperatively
Effect of RM on cardiac power index(CPI)	cardiac power index(CPI) measurement via arterial line as ml/min/m2	intraoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Effect of RM on Compliance	measurement of dynamic compliance by Ventilator as Cdyn	intraoperatively
Effect of RM on Oxygenation	measurement of oxygenation via obtaining partial blood oxygene pressure via arterial blood sample pulse oxymeter as %	İntraoperatively
Postoperative pulmonary comlications (infection, bronchospasm, pleural effusion, atelectasis, respiratory failure)	assessment of pulmonary complications	postoperative day 1 and 3

Collaborators and Investigators

• Sponsor: Balikesir University
• Investigators: Study Chair: Ahmet Koroglu, Professor, medical doctor, Balikesir University

Study record dates

Study Major Dates

• Study Start (Actual): January 9, 2023
• Primary Completion (Actual): August 1, 2023
• Study Completion (Actual): August 15, 2023

Study Registration Dates

• First Submitted: April 9, 2025
• First Submitted That Met QC Criteria: December 9, 2025
• First Posted (Actual): December 23, 2025

Study Record Updates

• Last Update Posted (Actual): December 23, 2025
• Last Update Submitted That Met QC Criteria: December 9, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Keywords: laparoscopic surgery; lung protective ventilation; haemodynamic changes; recruitment manoeuvre
• Other Study ID Numbers: BalikesirU OSagır 001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

Drug and device information, study documents

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