- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT03776292
Cardiopulmonary Changes Prolonged Surgical Abdominal Retractors Application in Supine Versus Lateral Position
2019년 6월 18일 업데이트: Mohamed Abd Latif Ghanim, Mansoura University
Cardiopulmonary Effects of Prolonged Surgical Abdominal Retractors Application in Supine Versus Lateral Position During General Anesthesia
Introduction: Dynamic and static compliance should be calculated as a routine part of ventilator monitoring.
Dynamic and static compliance are 60-100 mL/cm H2O.
A decrease in dynamic compliance without a change in the static compliance suggests an acute increase in airway resistance and can be assessed further by comparing peak pressure and plateau pressure.
The normal gradient is approximately 10 cm H2O.
A gradient >10 cm H2O may be secondary to endotracheal tube obstruction, mucous plugging, or bronchospasm.
If volume is constant, acute changes in both dynamic and static compliance suggest a decrease in respiratory system compliance that may be caused by worsening increasing abdominal pressures.
When static compliance is <25 mL/cm H2O, ventilator weaning may be difficult secondary to tachypnea during spontaneous breathing trials.
(1) Aim of the work: to detect the cardiopulmonary burden of surgical ring retractors application during abdominal surgeries in supine versus lateral position (cancer bladder for supine position and open surgical nephrectomy for lateral position).
Hypothesis: Abdominal retractors application would produce more cardiopulmonary instability during lateral position than during supine position for abdominal surgery.
Patient & Methods: This comparative prospective randomized study, will be done on ASA I-II patients, both sexes, Age 18 - 65 year, to compare pulmonary compliance and cardiac performance before, during and after surgical self-retaining abdominal retractors application patients will be divided into 2 groups; 1st group (S) will undergo orthotropic cancer bladder diversion and the 2nd group (L) both supine and lateral position for open surgical nephrectomy for lateral position.
연구 개요
상세 설명
Introduction: Dynamic and static compliance should be calculated as a routine part of ventilator monitoring.
Dynamic and static compliance are 60-100 mL/cm H2O.
A decrease in dynamic compliance without a change in the static compliance suggests an acute increase in airway resistance and can be assessed further by comparing peak pressure and plateau pressure.
The normal gradient is approximately 10 cm H2O.
A gradient >10 cm H2O may be secondary to endotracheal tube obstruction, mucous plugging, or bronchospasm.
If volume is constant, acute changes in both dynamic and static compliance suggest a decrease in respiratory system compliance that may be caused by worsening increasing abdominal pressures.
When static compliance is <25 mL/cm H2O, ventilator weaning may be difficult secondary to tachypnea during spontaneous breathing trials.
(1) Aim of the work: to detect the cardiopulmonary burden of surgical ring retractors application during abdominal surgeries in supine versus lateral position (cancer bladder for supine position and open surgical nephrectomy for lateral position).
Hypothesis: Abdominal retractors application would produce more cardiopulmonary instability during lateral position than during supine position for abdominal surgery.
Patient & Methods: This comparative prospective randomized study, will be done on ASA I-II patients, both sexes, Age 18 - 65 year, to compare pulmonary compliance and cardiac performance before, during and after surgical self-retaining abdominal retractors application patients will be divided into 2 groups; 1st group (S) will undergo orthotropic cancer bladder diversion and the 2nd group (L) both supine and lateral position for open surgical nephrectomy for lateral position.
Study will be done at Mansoura University Hospital, during the year 2018, for 4 month duration, starting predected date=1-11-2018 actual study start date=15-12-2018[ NB. by mistake in the 1st registration i have regestered the study protocol predicted time of study start but actually the study started on 15-12-2018 thats why i changed the date more than one time ] till 30-3-2019 after approval of IRB (Institutional Review Board), Mansoura Faculty of Medicine.
Primary outcome; composite 1ry outcome [1-Dynamic pulmonary compliance.2-
Cardiac Index] during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups.
Secondary outcome: Static lung compliance, Cardiac output, Stroke volume SV - stroke volume variability (SVV)-Cardiac performance index CPI, O2 delivery DIO2.
Noninvasive Intraoperative hemodynamic (MBP, HR, O2 saturation)] during and after surgical ring retractor application compared to the same variable reading prior retractor application and in between both groups.
연구 유형
관찰
등록 (실제)
40
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 장소
-
-
Dakahlia
-
Mansourah, Dakahlia, 이집트, 35511
- Mansoura faculty of Medicine- Mansoura Urology and nephrology center
-
-
참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
공부할 수 있는 나이
18년 (성인, 고령자)
건강한 자원 봉사자를 받아들입니다
아니
연구 대상 성별
모두
샘플링 방법
확률 샘플
연구 인구
-Patients admitted to the Urology Department, Mansoura Urology and Nephrology center, Faculty of medicine Mansoura University .
설명
Inclusion Criteria:
- ASA I-II patients
- both sexes
- Age 18 - 65 year
- surgical time ≥ 6hours for Orthotopic urinary bladder diversion surgery for cancer bladder patients and 3 hours for open surgical nephrectomy.
Exclusion Criteria:
- Body mass index (BMI) greater than 35 kg. m-2.
- Asthma requiring bronchodilator therapy.
- Chronic Obstructive Pulmonary Disease, GOLD classification III and IV.
- Severe pulmonary disease.
- Hemodynamic instability (hypotension or tachycardia).
- History of congestive heart failure or New York Heart Association (NYHA) functional class IV
- Right ventricular dysfunction.
- Severe valvular heart disease.
- Intra-cardiac shunts.
- Intracranial hypertension.
- Cardiac rhythm other than regular sinus.
- Severe chronic kidney disease (glomerular filtration rate < 30 ml. min-1. 1.73 m2).
- Liver cirrhosis (Child Pugh class B or C).
- Pregnancy.
- Previous thoracic surgery (lobectomy, bilobectomy, or pneumonectomy).
- Lung metastatic surgery.
- Previous receiving chemotherapy.
- Emergency surgery.
- Preoperative need for invasive mechanical ventilation.
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
코호트 및 개입
그룹/코호트 |
개입 / 치료 |
---|---|
supine position group= Group (S)
1st group of 20 patients will undergo urinary bladder cystectomy and orthotopic urinary diversion lying supine with ring abdominal retractors
|
Primary outcome; composite 1ry outcome [1-Dynamic pulmonary compliance monitoring.2-
Cardiac Index monitoring] during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups.
Secondary outcome: Static lung compliance, Cardiac output, Stroke volume SV - stroke volume variability (SVV)-Cardiac performance index, O2 delivery DIO2.
Noninvasive Intraoperative hemodynamic (MBP, HR, O2 saturation)] during and after surgical ring retractor application compared to the same variable reading prior retractor application and in between both groups.
|
lateral position group = Group (L)
2nd group of 20 patients will undergo surgical open nephrectomy lying lateral position with self retaining abdominal retractors
|
Primary outcome; composite 1ry outcome [1-Dynamic pulmonary compliance monitoring.2-
Cardiac Index monitoring] during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups.
Secondary outcome: Static lung compliance, Cardiac output, Stroke volume SV - stroke volume variability (SVV)-Cardiac performance index, O2 delivery DIO2.
Noninvasive Intraoperative hemodynamic (MBP, HR, O2 saturation)] during and after surgical ring retractor application compared to the same variable reading prior retractor application and in between both groups.
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
-non invasive Dynamic pulmonary compliance .
기간: mean dynamic compliance at minutes 30,60,90,120,180,210 240 post retractor application compared to mean dynamic compliance at minutes 10,20,30,post endotracheal intubation(Basal Value preretractor application)
|
dynamic pulmonary compliance during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
mean dynamic compliance at minutes 30,60,90,120,180,210 240 post retractor application compared to mean dynamic compliance at minutes 10,20,30,post endotracheal intubation(Basal Value preretractor application)
|
Non invasive Cardiac Index
기간: mean Non invasive Cardiac Index at minutes 30,60,90,120,180,210 240 post retractor application compared to mean Non invasive Cardiac Index at minutes 10,20,30,post endotracheal intubation(Basal Value preretractor application)
|
Cardiac index monitoring during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
mean Non invasive Cardiac Index at minutes 30,60,90,120,180,210 240 post retractor application compared to mean Non invasive Cardiac Index at minutes 10,20,30,post endotracheal intubation(Basal Value preretractor application)
|
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Static lung compliance
기간: After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
Static lung compliance during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
Cardiac output.
기간: After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
Cardiac output.
during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
Stroke volume SV
기간: After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
Stroke volume SV. during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
- stroke volume variability (SVV)
기간: After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
Stroke volume variability (SVV)during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
-Cardiac performance index CPI
기간: After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
Cardiac performance index during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
Oxygen delivery DIO2
기간: After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
Oxygen delivery DIO2 during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
. Noninvasive Intraoperative MBP
기간: After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
Noninvasive Intraoperative MBP during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
HR
기간: After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
HR during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
arterial O2 saturation(SaO2%)
기간: After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
SaO2 saturation during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
End tidal Co2 EtCO2
기간: After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
End tidal Co2 EtCO2 during and after surgical retractor application compared to the same variables reading prior retractor application and in between both groups
|
After endotracheal intubation recorded 3 times every 10 minutes -After Abdominal retractors application recorded every 30 minutes for 6 readings -After retractor removal 3 times every 10 minutes
|
공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
수사관
- 수석 연구원: Mohamed A. Ghanem, A professor, Mansoura Univeristy
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (실제)
2018년 12월 15일
기본 완료 (실제)
2019년 3월 30일
연구 완료 (실제)
2019년 3월 30일
연구 등록 날짜
최초 제출
2018년 12월 9일
QC 기준을 충족하는 최초 제출
2018년 12월 12일
처음 게시됨 (실제)
2018년 12월 14일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2019년 6월 20일
QC 기준을 충족하는 마지막 업데이트 제출
2019년 6월 18일
마지막으로 확인됨
2019년 6월 1일
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
- R.18.11.337
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
아니
미국 FDA 규제 기기 제품 연구
아니
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
Cardio-pulmonary에 대한 임상 시험
-
University of Colorado, Denver모병단심실 | 폐 혈관 저항 이상 | 대사체학 | 우수한 Cavo-Pulmonary 문합 | 엔도텔린미국
monitoring에 대한 임상 시험
-
Seoul National University HospitalSeoul National University모집하지 않고 적극적으로
-
Singapore General HospitalKK Women's and Children's Hospital; SingHealth Polyclinics완전한
-
Kaohsiung Medical University Chung-Ho Memorial...모병
-
Royal Brompton & Harefield NHS Foundation TrustUniversity of Oxford; National Institute for Health Research, United Kingdom완전한
-
University of AarhusOdense University Hospital; Aarhus University Hospital; Protac A/S; Innovation Fund Denmark모병