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This study evaluates the incidence of postoperative atelectasis after general anesthesia with prone position using lung ultrasound in children age < 3 years.
Atelectasis is common in pediatric patients after general anesthesia. Particularly, infants are more likely to develop atelectasis or ventilation-perfusion imbalance after general anesthesia because of the immature ribs and respiratory muscles, the high compliance of the rib cage and a significant reduction in functional residual capacity (FRC) during general anesthesia. Previous studies have reported that alveolar recruitment and positive end-expiratory pressure (PEEP) can be used to reduce atelectasis in children. Also, previous studies have shown that the lung ultrasound can be used to evaluate the degree of atelectasis during general anesthesia in children.
However, none of the previous studies investigated the incidence of atelectasis, the effect of alveolar recruitment, and the PEEP in pediatric patients under general anesthesia with prone position. The purpose of this study was to evaluate previously described parameters using lung ultrasound.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Repetitive recruitment with PEEP | Experimental | One alveolar recruitment at before surgery and repetitive alveolar recruitment (once an hour) during surgery |
|
| One recruitment with PEEP | Active Comparator | One alveolar recruitment at before surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Repetitive recruitment with PEEP | Procedure | Apply sustained airway pressure of 30-40 cmH2O for 10-20 seconds before suegery and once an hour during surgery. PEEP is set to 7 cmH2O. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of pre-extubation atelectasis | Incidence of pre-extubation atelectasis accessed by lung ultrasound | postoperative 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of intraoperative atelectasis after intubation | Incidence of intraoperative atelectasis after induction accessed by lung ultrasound | intraoperative |
| Incidence of intraoperative atelectasis after position change to prone |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hee Kim, MD | Seoul National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| SNUH | Seoul | Jongnogu | 03080 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32169254 | Derived | Jang YE, Ji SH, Kim EH, Lee JH, Kim JT, Kim HS. Effect of regular alveolar recruitment on intraoperative atelectasis in paediatric patients ventilated in the prone position: a randomised controlled trial. Br J Anaesth. 2020 May;124(5):648-655. doi: 10.1016/j.bja.2020.01.022. Epub 2020 Mar 10. |
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| ID | Term |
|---|---|
| D001261 | Pulmonary Atelectasis |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D011175 | Positive-Pressure Respiration |
| ID | Term |
|---|---|
| D012121 | Respiration, Artificial |
| D058109 | Airway Management |
| D013812 | Therapeutics |
| D012138 | Respiratory Therapy |
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| One recruitment with PEEP | Procedure | Apply sustained airway pressure of 30-40 cmH2O for 10-20 seconds before surgery. PEEP is set to 7 cmH2O. |
|
Incidence of intraoperative atelectasis after position change to prone accessed by lung ultrasound
| intraoperative |
| Incidence of intraoperative and postoperative (within 12hr) desaturation | Oxygen saturation by pulse oximetry (SpO2) ≤ 95% or 10% below the baseline value | intraoperative and postoperative (within 12hr) |
| Incidence of intraoperative hypotension | Systolic blood pressure (SBP) ≤ 20% below the baseline value | intraoperative |