The Role Intraoperative Salbutamol Inhaler in Preventing Atelectasis

The Role Intraoperative Salbutamol Inhaler Usage as Part of Intraoperative Regimen in Preventing Atelectasis Following Thoracic, Abdominal and Spinal Surgery in Diabetics Population

Atelectasis is considered a common complication in the perioperative period, especially following surgeries under general anesthesia. Postoperative atelectasis could occur anytime during the perioperative period from intraoperative period to 24 hours postoperative and contribute to a variety of other complications, including hypoxemia and pneumonia. In the literature, several methods were utilized to combat this phenomenon, therefore, we investigate the role of intraoperative salbutamol in reducing the incidence of atelectasis. It is well known that salbutamol could be an adjunctive bronchodilator medication used in the intraoperative anesthetic regimens.

Study Overview

• Status: Not yet recruiting
• Conditions: Diabete Mellitus; Atelectases, Postoperative Pulmonary
• Intervention / Treatment: Drug: Salbutamol (Ventolin®)

Detailed Description

Atelectasis is the collapse or incomplete expansion of the lung or a part of it, resulting in impaired gas exchange and potential hypoxemia. It is a common complication in various clinical settings, particularly after surgery, and can contribute to increased morbidity and prolonged hospital stay. The incidence of atelectasis varies widely depending on the patient population and type of surgical procedure. Postoperative atelectasis is reported in up to 90% of patients undergoing general anesthesia, with higher rates observed in thoracic and upper abdominal surgeries. In pediatric populations, the incidence may range from 10-25%, especially following gastrointestinal or thoracic procedures. Key risk factors include general anesthesia, postoperative pain, obesity, advanced age, smoking, prolonged immobility, neuromuscular disorders, and mechanical ventilation. These factors contribute to reduced diaphragmatic motion, impaired mucociliary clearance, and decreased alveolar ventilation. There are several causes of atelectasis in the postoperative period which results from a combination of factors that impair normal lung expansion and ventilation as reduced functional residual capacity as general anesthesia decreases FRC below closing volume, especially in dependent lung areas, promoting alveolar collapse. Impaired diaphragmatic function as pain and muscle relaxation reduce diaphragmatic motion, limiting lung inflation post-surgery. In addition, mucus retention due to suppressed cough reflex and ciliary function leads to resorptive (obstructive) atelectasis. Another important mechanism for atelectasis is airway obstruction and reflex bronchospasm. Management of atelectasis depends mainly on prevention and lung re-expansion strategies and it is divided according to period. In the preoperative period, smoking cessation at least 4-8 weeks before surgery reduces risk and patient education on deep breathing and coughing exercises. In the intraoperative period, the use of lung-protective ventilation as low tidal volumes with adequate PEEP (positive end-expiratory pressure) to prevent alveolar collapse [5]. Recruitment maneuvers during surgery to reopen collapsed alveoli. Furthermore, the use of postoperative nebulizers such as bronchodilator (salbutamol) and steroids has been shown to benefit those patients. Our hypothesis is that intraoperative salbutamol inhaler will lead to a reduction in the incidence and severity of atelectasis especially in diabetic patients. Therefore our primary aim of the study is to examine the incidence of atelectasis in diabetic patients compared to standard anesthesia and surgery techniques in our institution.in addition, outcomes such as severity of the atelectasis, overall hospital stay, side effects of salbutamol, hypoxia and pneumonia.

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Early Phase 1

Contacts and Locations

• Study Contact: Name: Diab Bani Hani Bani Hani; Phone Number: +962798661232; Email: dabanihani@just.edu.jo

Study Locations

• Jordan
  • Irbid, Jordan
    • King Abdullah University Hospital
    • Contact: Principal Investigator Principal Investigator

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• The study will include patients aged 18-70 years
• American Society of Anesthesiologists (ASA) physical status of I or II
• Will undergo thoracic, abdominal or spinal surgery

Exclusion Criteria:

• cardiac conditions other than hypertension like arrhythmia
• previous cardiac surgeries and valvular heart diseases

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: salbutamol group for diabetic patients; for diabetic patients	Drug: Salbutamol (Ventolin®); -4 puffs of salbutamol (each puff = 100 µg, total dose 200-400 µg)
No Intervention: no intervention for diabetic
Experimental: salbutamol group for non-diabetic patients; for non-diabetic patients	Drug: Salbutamol (Ventolin®); -4 puffs of salbutamol (each puff = 100 µg, total dose 200-400 µg)
No Intervention: no intervention for non-diabetic patients; for non-diabetic patients

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative atelectasis (vital signs)	All patients will undergo a thorough medical history, appropriate physical examination, and relevant investigations according to their clinical needs. Particular attention will be given to vital signs, especially pulse oximetry.	5 months
Postoperative atelectasis (x-ray)	All patients will undergo a chest X-ray to investigate for atelectasis.	5 months
Postoperative atelectasis (blood gases)	Postoperatively blood gases will be assessed to investigate for atelectasis. This will be done through arterial blood gases sample at 24 hours postoperative.	5 months

Collaborators and Investigators

• Sponsor: King Abdullah University Hospital
• Collaborators: Jordan University of Science and Technology

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: May 3, 2026
• First Submitted That Met QC Criteria: May 11, 2026
• First Posted (Actual): May 15, 2026

Study Record Updates

• Last Update Posted (Actual): May 15, 2026
• Last Update Submitted That Met QC Criteria: May 11, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: atelectasis; pulmonary; bronchodilator; salbutamol
• Additional Relevant MeSH Terms: Endocrine System Diseases; Metabolic Diseases; Respiratory Tract Diseases; Lung Diseases; Glucose Metabolism Disorders; Nutritional and Metabolic Diseases; Diabetes Mellitus; Pulmonary Atelectasis; Organic Chemicals; Amines; Alcohols; Amino Alcohols; Ethanolamines; Phenethylamines; Ethylamines; Albuterol
• Other Study ID Numbers: Apr2026/191-49

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