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Perioperative Change of Regional Ventilation During Spontaneous Breathing

2016年2月29日 更新者:Wuerzburg University Hospital
Perioperative changes in regional ventilation by pulmonary electrical impedance tomography and spirometry will be investigated in patients at risk for postoperative pulmonary complications. Those patients undergo abdominal and limb operations. In a pilot study arm electrical impedance tomography is tested in patients receiving osteosynthesis of serial rib fractures.

研究概览

地位

完全的

条件

干预/治疗

详细说明

Postoperative pulmonary complications (Defined as pulmonary infection, pleural effusion, atelectasis, pneumothorax, bronchospasm, aspiration pneumonitis or respiratory insufficiency subsequent to surgery) increase the morbidity and mortality of surgical patients. Several independent factors determined by the patients' characteristics and the operative procedure increase the risk for those complications. The postoperative decrease of values measured by spirometry, such as the forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), were found in patients after major surgical procedures for several days. The postoperative reduction of those measurement can be the result of general functional limitations in those patients (e.g. by postoperative pain) or the result of a regional postoperative pulmonary complication (e.g. atelectasis, pleural effusion). The method of the electrical impedance tomography (EIT) enables to visualize the regional ventilation within a transversal section of the lung in real time. Studies examining the change of pulmonary EIT for several days postoperatively in spontaneously breathing patients are lacking. The aim of the present study is to examine perioperative changes in regional ventilation in spontaneously breathing patients during their recovery after abdominal and limb surgery. Moreover, the association of those changes with expected changes in spirometry is tested. Finally, in patients with evident postoperative pulmonary complications the value of pulmonary EIT to detect those changes is investigated. The study should improve the knowledge about the development of postoperative pulmonary complications and test the scientific and clinical value of pulmonary EIT in those spontaneously breathing patients.

In a group of patients undergoing osteosynthesis of a flail chest, it is tested how regional ventilation changes by these operations and whether pulmonary EIT is actually usable in these patients.

研究类型

观察性的

注册 (实际的)

72

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Würzburg、德国、97080
        • University of Würzburg

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

取样方法

非概率样本

研究人群

adult inpatients undergoing elective surgery

描述

Inclusion Criteria:

  • Adult
  • Inpatient
  • Surgery under general anesthesia with and without additional regional anesthesia
  • increased risk for postoperative pulmonary complications according to the ARISCAT-Score (except pilot arm for osteosynthesis of flail chest)

Exclusion Criteria:

  • Missing informed consent
  • Outpatient
  • Emergency procedure
  • Revision surgery of hospitalized patients
  • Operation under local or regional anesthesia alone
  • Expected postoperative ventilation
  • Expected hospital stay of less than three days
  • Pregnancy
  • Allergy against material of the electrode belt (silicone rubber, stainless steel, gold-plated brass)
  • Injured, inflamed or otherwise affected skin within the target region of the electrode belt
  • Unstable spine injury
  • Body mass index of more than 50 kg/m2
  • Incapacity to lie quietly for the examination
  • Pacemaker, defibrillator or other active implant
  • Reoperation before the examination at the third postoperative day

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

队列和干预

团体/队列
干预/治疗
abdominal surgery
27 patients undergoing abdominal surgery having an elevated risk for postoperative pulmonary complications will be examined by perioperative pulmonary function tests
Pulmonary electrical impedance tomography, spirometry, pulse oximetry and query performed preoperatively, at the first and the third postoperative day
limb surgery
27 patients undergoing upper and lower limb surgery having an elevated risk for postoperative pulmonary complications will be examined by perioperative pulmonary function tests
Pulmonary electrical impedance tomography, spirometry, pulse oximetry and query performed preoperatively, at the first and the third postoperative day
flail chest
10 patients undergoing an operative stabilization of a flail chest will be examined by perioperative pulmonary function tests
Pulmonary electrical impedance tomography, spirometry, pulse oximetry and query performed preoperatively, at the first and the third postoperative day

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Change from baseline in regional ventilation at the first postoperative day
大体时间:baseline and 1. postoperative day
Regional ventilation is measured by pulmonary electrical impedance tomography. The change in the calculated 'Center of Ventilation' in the sagittal direction is used for the primary outcome measure. Power calculation accounts for the use of two time points for the primary outcome measure.
baseline and 1. postoperative day
Change from baseline in regional ventilation at the third postoperative day
大体时间:baseline and 3. postoperative day
Regional ventilation is measured by pulmonary electrical impedance tomography. The change in the calculated 'Center of Ventilation' in the sagittal direction is used for the primary outcome measure. Power calculation accounts for the use of two time points for the primary outcome measure.
baseline and 3. postoperative day

次要结果测量

结果测量
措施说明
大体时间
Change in forced vital capacity (FVC)
大体时间:baseline, 1. and 3. postoperative day
Measured by spirometry. The best value of three attempts is used.
baseline, 1. and 3. postoperative day

其他结果措施

结果测量
措施说明
大体时间
Change in forced expiratory volume in one second (FEV1)
大体时间:baseline, 1. and 3. postoperative day
Measured by spirometry. The best value of three attempts is used.
baseline, 1. and 3. postoperative day
Change in peripheral oxygen saturation
大体时间:baseline, 1. and 3. postoperative day
Measured by pulse oximetry
baseline, 1. and 3. postoperative day
Change in pain score
大体时间:baseline, 1. and 3. postoperative day
Measured by visual analogue scale
baseline, 1. and 3. postoperative day
Change in respiratory rate
大体时间:baseline, 1. and 3. postoperative day
Measured by electric impedance tomography
baseline, 1. and 3. postoperative day
pulmonary complications
大体时间:baseline, 1., 3. and 7. postoperative day or at discharge
Defined as pulmonary infection, pleural effusion, atelectasis, pneumothorax, bronchospasm, aspiration pneumonitis or respiratory insufficiency
baseline, 1., 3. and 7. postoperative day or at discharge

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

调查人员

  • 首席研究员:Markus Kredel, PD. Dr. med、University of Würzburg, Department of Anaesthesia and Critical Care

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2015年1月1日

初级完成 (实际的)

2016年2月1日

研究完成 (实际的)

2016年2月1日

研究注册日期

首次提交

2014年12月1日

首先提交符合 QC 标准的

2015年4月13日

首次发布 (估计)

2015年4月17日

研究记录更新

最后更新发布 (估计)

2016年3月1日

上次提交的符合 QC 标准的更新

2016年2月29日

最后验证

2016年2月1日

更多信息

与本研究相关的术语

其他研究编号

  • perioperativeEIT

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