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Background:
There is a lack of studies regarding Optimal (best) positive end-expiratory pressure (PEEP) in prone position during surgery, and its relation with optimal PEEP in supine position.
Hypothesis:
In patients undergoing scheduled spinal surgery, optimal PEEP in the prone position is lower than optimal PEEP in the supine position.
Aims:
To assess the difference optimal PEEP in supine vs. prone positions in patients undergoing spine surgery.
To evaluate the changes in optimal PEEP in prone position throughout the surgical procedure.
Methods:
Observational study, one center. Main variable: optimal PEEP. Secondary variables: PaO2, pCO2 and dynamic compliance (Crd) in prone and supine position.
Recruitment: Patients scheduled for spine surgery were Main outcome: Optimal PEEP determined after a pulmonary recruitment manoeuvre in supine and in prone position and every hour during the surgery in prone position.
Secondary outcomes: Pulmonary compliance, blood gas analysis and hemodynamic parameters
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Evaluation of PEEP in prone position | Other | Assessment of optimal Positive End-Expiratory Pressure (PEEP) in patients undergoing scheduled spine surgery in prone position. |
| Measure | Description | Time Frame |
|---|---|---|
| Positive End-Expiratory Pressure (PEEP) | Positive End-Expiratory Pressure (cmH2O) in supine position | 10 minutes after intubation |
| Positive End-Expiratory Pressure (PEEP) | Positive End-Expiratory Pressure (cmH2O) in prone position | 10 minutes after positioning |
| Change in Positive End-Expiratory Pressure (PEEP) | Variation of Positive End-Expiratory Pressure (cmH2O) during surgery in prone position with respect to PEEP value at 10 minutes after positioning | From determination of optimal PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours) |
| Measure | Description | Time Frame |
|---|---|---|
| Static compliance | Tidal volume / Plateau pressure ratio (mL/cmH2O) in supine position | 10 minutes after intubation |
| Static compliance | Tidal volume / Plateau pressure ratio (mL/cmH2O) in prone position |
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Inclusion Criteria:
Exclusion Criteria:
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Patients scheduled for spine surgery that requires prone decubitus.
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| Name | Affiliation | Role |
|---|---|---|
| LluÃs Gallart, Dr | Hospital del Mar (Barcelona, Spain) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital del Mar | Barcelona | 08003 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24283226 | Background | Slutsky AS, Ranieri VM. Ventilator-induced lung injury. N Engl J Med. 2013 Nov 28;369(22):2126-36. doi: 10.1056/NEJMra1208707. No abstract available. | |
| 21045639 | Background | Canet J, Gallart L, Gomar C, Paluzie G, Valles J, Castillo J, Sabate S, Mazo V, Briones Z, Sanchis J; ARISCAT Group. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology. 2010 Dec;113(6):1338-50. doi: 10.1097/ALN.0b013e3181fc6e0a. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Nov 7, 2024 | |
| Reset | Jan 2, 2025 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Nov 7, 2024 | Jan 2, 2025 |
| ID | Term |
|---|---|
| D053120 | Respiratory Aspiration |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D016684 | Prone Position |
| ID | Term |
|---|---|
| D011187 | Posture |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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| 10 minutes after positioning |
| Change in static compliance | Variation of static compliance (Tidal volume / Plateau pressure ratio, in mL/cmH2O) during surgery in prone position | Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours) |
| Arterial oxygen pressure (PaO2) | Partial pressure of oxygen (mmHg) in supine position | 10 minutes after intubation |
| Arterial oxygen pressure (PaO2) | Partial pressure of oxygen (mmHg) in prone position | 10 minutes after positioning |
| Change in arterial oxygen pressure (PaO2) | Variation of partial pressure of oxygen (mmHg) during surgery in prone position | Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours) |
| Arterial carbon dioxide pressure (PaCO2) | Partial pressure of carbon dioxide (mmHg) in supine position | 10 minutes after intubation |
| Arterial carbon dioxide pressure (PaCO2) | Partial pressure of carbon dioxide (mmHg) in prone position | 10 minutes after positioning |
| Change in arterial carbon dioxide pressure (PaCO2) | Variation of partial pressure of carbon dioxide (mmHg) during surgery in prone position | Measured at the same time as Auto PEEP until the first hour and then every hour, assessed up to the end of surgery (maximum 6 hours) |
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