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Objective: to compare the effect of alveolar recruitment manouver through stepwise increase and decrease in airway pressure or sustained 30 secondes 30 cmH2O continuous positive airway pressure on cardiac stroke volume estimated by oesophageal doppler in preload independent anesthetized patients scheduled for surgery.
Following anesthesia and preload optimisation guided by cardiac stroke volume, patients will be randomised to one alveolr recruitment manoeuver :
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CPAP30 | Active Comparator | a 30 secondes 30 cmH2O continuous positive airway pressure applied after the orotracheal intubation will be checked and secured following induction of general anesthesia |
|
| STEP30 | Active Comparator | a stepwise increase (+5 cmH2O) in postivie airway pressure from +5 cmH2O to +30 cmH2O and decrease (-5 cmH2O) from +30 cmH2O to +5 cmH2O applied after the orotracheal intubation will be checked and secured following induction of general anesthesia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| alveolar recruitment manoeuver | Procedure | alveolar recruitment manoeuver are recommended during general anesthesia to prevent pulmonary atelectasis |
|
| Measure | Description | Time Frame |
|---|---|---|
| cardiac stroke volume | change in cardiac stroke volume during the alveolar recruitment manoeuver | 1 min |
| Measure | Description | Time Frame |
|---|---|---|
| arterial pressure | change in arterial pressure during the alveolar recruitment manoeuver | 1 min |
| recovery at 3 min | recovery of cardiacstroke volume and arterial pressure 3 min after the end of alveolar recruitment manoeuver |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Caen | Recruiting | Caen | 14000 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38017197 | Derived | Dupont K, Lefrancois V, Delahaye A, Sanz M, Hestin R, Doublet T, Parienti JJ, Hanouz JL. Change in stroke volume during alveolar recruitment maneuvers through transient continuous positive airway pressure or stepwise increase in positive end expiratory pressure in anesthetized patients: a prospective randomized double-blind study. Can J Anaesth. 2024 Feb;71(2):224-233. doi: 10.1007/s12630-023-02644-7. Epub 2023 Nov 28. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Dec 13, 2022 | |
| Reset | Oct 11, 2023 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Dec 13, 2022 | Oct 11, 2023 |
randomised parallel groups. randomisation between 2 groups equilibated by randomised blocks of 4, 6 or 8
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The patient will not know the allocation group because he will be anesthetised before randomisation. The care provider (anesthetist) will not know the allocation group because the intervention will be applied by an independent investigator not involved in care of the patient.
| 3 min |