Effect of Recruitment Maneuvers Plus Optimal PEEP Versus... | NCT03635281

NCT03635281

Protocol Section

Identification Module

Results Section

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Annotation Section

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Document Section

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Derived Section

Miscellaneous Info Module

Status Module

Oversight Module

Description Module

Design Module

Interventional Study Design

Biospecimen

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No data is available for this block.

Arms/Interventions Module

Arm Groups

Label	Type	Description	Intervention Names
PEEP group	Experimental	In this group the a PEEP level will be added after 20 minutes from OLV. PEEP values will be chosen according to the best static compliance with an incremental trial (i.e. starting from ZEEP, the PEEP values will be increased in step of 2 cmH2O each until the best compliance is reached)	Procedure: incremental PEEP
RM+PEEP group	Experimental	Recruitment maneuvers will be performed as follow Recruitment maneuvers set FIO2 at 1.0 Ppeak limit at 45 cmH2O Respiratory rate set at 6 I:E set at 1:1 Raise the VT at step of 2 ml/kg PBW until the Pplat is between 30-40 cmH2O If the maximum VT is set without rasing the Pplat, raise PEEP Allow three respiratory cycles with Pplat between 30 and 40 cmH2O End of RM The recruitment manouvers will be performed after 20 minutes of OLV. At the end of the RM, the VT will be set back to 5 ml/kg while the PEEP will be chosen according to the best static compliance with a decremental trial (from 16 cmH2O, lowering PEEP with steps of 2 cmH2O each until the best compliance is reached).	Procedure: Recruitment manoeuvers

Interventions

Name	Type	Description	Arm Group Labels	Other Names
Recruitment manoeuvers	Procedure	Recruitment manoeuvers will be performed as follow Recruitment manoeuvers set FIO2 at 1.0 Ppeak limit at 45 cmH2O Respiratory rate set at 6 I:E set at 1:1 Raise the VT at step of 2 ml/kg PBW until the Pplat is between 30-40 cmH2O If the maximum VT is set without rasing the Pplat, raise PEEP Allow three respiratory cycles with Pplat between 30 and 40 cmH2O End of RM The recruitment manouvers will be performed after 20 minutes of OLV. At the end of the RM, the VT will be set back to 5 ml/kg while the PEEP will be chosen according to the best static compliance with a decremental trial (from 16 cmH2O, lowering PEEP with steps of 2 cmH2O each until the best compliance is reached).

Measure	Description	Time Frame
pulmonary shunt, expressed as percentage, measured by ALPE system		20 minutes after intervention

Measure	Description	Time Frame
intraoperative driving pressure, measured as plateau pressure - PEEP		20 minutes after intervention

Measure	Description	Time Frame
intraoperative oxygenation, measured as PaO2/FIO2 ratio		20 minutes after intervention

Eligibility Module

Facility	Status	City	State	ZIP	Country	Contacts
Università di Ferrara		Ferrara		44121	Italy

References Module

Citations

PubMed Identifier	Type	Citation	Retractions
29215365	Result	Spadaro S, Grasso S, Karbing DS, Fogagnolo A, Contoli M, Bollini G, Ragazzi R, Cinnella G, Verri M, Cavallesco NG, Rees SE, Volta CA. Physiologic Evaluation of Ventilation Perfusion Mismatch and Respiratory Mechanics at Different Positive End-expiratory Pressure in Patients Undergoing Protective One-lung Ventilation. Anesthesiology. 2018 Mar;128(3):531-538. doi: 10.1097/ALN.0000000000002011.
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