The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing Gynecologic Laparoscopic Surgery With Trendelenburg Position
2012年9月27日 更新者:Tae Soo Hahm、Samsung Medical Center
In patients undergoing gynecologic laparoscopic surgery with trendelenburg position, the disturbance of pulmonary gas exchange frequently occurs due to high intra-abdominal pressure.
The investigators tried to evaluate the effect of various inspiratory to expiratory ratio on pulmonary gas exchange by randomized controlled trial.
研究概览
地位
完全的
详细说明
In patients undergoing gynecologic laparoscopic surgery with trendelenburg position, the disturbance of pulmonary gas exchange frequently occurs due to high intra-abdominal pressure.
During the laparoscopic surgery with abdominal gas insufflation, gas exchange disturbance such as CO2 retention, hypoxemia occurs in addition to high plateau airway pressure.
The usual strategy against these kinds of problem is pressure-controlled ventilation.
However, the gas exchange problem especially CO2 retention can not be solved in some cases.
The inverse-ratio ventilation (IRV), which prolongs the inspiratory time greater than expiratory time, can be applied for adult respiratory distress syndrome.
The efficacy of IRV is to improve gas-exchange status by increasing mean airway pressure and alveolar recruitment.
There have been several clinical investigations which applied IRV during general anesthesia.
However, there have been debates about the effect of IRV during general anesthesia.
Therefore, we tried to apply the IRV for subjects undergoing laparoscopic surgery, and evaluate the effect of different I:E ratio on the pulmonary gas exchange and respiratory mechanics.
研究类型
介入性
注册 (实际的)
100
阶段
- 不适用
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
-
-
-
Seoul、大韩民国、135-710
- Samsung Seoul Hospital, Samsung Medical Center
-
-
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
20年 至 65年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- patients undergoing elective gynecologic laparoscopic surgery
- the duration of pneumoperitoneum during laparoscopic surgery is more than 40 minutes
Exclusion Criteria:
- ASA (American society of anesthesiologists) classification of the subjects more than III.
- Age under 20, or more than 65 years.
- Past history of pneumothorax, COPD, asthma.
- Patients with ischemic heart disease, valvular heart disease.
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
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
有源比较器:1:2组
常规I:E比例组,吸气时间:呼气时间=1:1
|
conventional I:E ratio of 1:2 is applied.
|
实验性的:1:1 group
1:1 I:E ratio group, inspiratory time : expiratory time = 1:1
|
I:E ratio of 1:1 is applied.
|
实验性的:2:1 group
inverse ratio group, inspiratory time : expiratory time = 2:1
|
Inverse I:E ratio of 2:1 is applied.
|
有源比较器:1:2 PEEP group
I:E ratio of 1:2 with external PEEP of 5 cm H2O
|
conventional I:E ratio of 1:2 is applied.
external positive end-expiratory pressure of 5 cmH2O is applied.
|
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 |
---|---|---|
动脉二氧化碳分压
大体时间:全身麻醉诱导后10分钟
|
动脉二氧化碳分压
|
全身麻醉诱导后10分钟
|
arterial CO2 partial pressure
大体时间:30 minutes after start of pneumoperitoneum
|
arteial CO2 partial pressure
|
30 minutes after start of pneumoperitoneum
|
arterial CO2 partial pressure
大体时间:60 minutes after start of pneumoperitoneum
|
arteial CO2 partial pressure
|
60 minutes after start of pneumoperitoneum
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
arterial O2 partial pressure
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
arterial O2 partial pressure
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
Mean airway pressure
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
Mean airway pressure
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
tidal volume (setting)
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
tidal volume (setting)
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
hemodynamic parameters
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
systolic/ diastolic blood pressure, heart rate, mean blood pressure
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
end-tidal CO2 partial pressure
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
end-tidal CO2 partial pressure
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
respiratory compliance
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
Dynamic compliance, Static compliance
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
Dead space
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
physiologic dead space / tidal volume (VD/VT)
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
work of breathing
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
work of breathing
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
peak inspiratory pressure
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
peak inspiratory pressure
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
plateau pressure
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
plateau pressure
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
positive end-expiratory pressure
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
positive end-expiratory pressure
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
tidal volume (exhaled)
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
tidal volume (exhaled)
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
minute ventilation
大体时间:10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
minute ventilation
|
10 min after induction, 30 and 60 min after start of pneumoperitoneum
|
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。
调查人员
- 研究主任:Tae Soo Hahm, M.D.,Ph.D.、Samsung Medical Center
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
2011年6月1日
初级完成 (实际的)
2012年3月1日
研究完成 (实际的)
2012年3月1日
研究注册日期
首次提交
2011年6月21日
首先提交符合 QC 标准的
2011年6月22日
首次发布 (估计)
2011年6月23日
研究记录更新
最后更新发布 (估计)
2012年10月1日
上次提交的符合 QC 标准的更新
2012年9月27日
最后验证
2012年9月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.