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The primary goal of this prospective, observational crossover study is to investigate mechanical and EIT (Electrical Impedance Tomography) differences between Volume-Controlled Ventilation (VCV) and Pressure-Regulated Volume Controlled Ventilation (PRVC) in pediatric patients undergoing general anesthesia with endotracheal intubation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single cohort | Each patient has received both ventilatory modes with same settings (tidal volume- TV, respiratory rate- RR, positive end expiratory pressure- PEEP- and inspired fraction of Oxygen - FiO2). Intra-lung compliance and global inhomogeneity Index (GI) were assessed though Electric Impedance Tomography (EIT) (PulmoVista 500, Draeger Medical, Germany), allowing at least five minutes after change of mode to let adequate time for gas distribution. At the same time, respiratory mechanics measures were obtained in quasi-static conditions after an inspiratory hold manoeuver, ensuring stability of plateau pressure (PPLAT). We assessed resistive (PIP-PPLAT) and elastic components (DeltaP and quasi-static compliance) of working pressure, and mechanical power as a marker of energy dissipation. |
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| Measure | Description | Time Frame |
|---|---|---|
| Intra-lung Compliance | Intra-lung Compliance is an EIT- based parameter which shows if, between the two modes of ventilation, there is a net gain or loss of intraprenchimal compliance. This is expressed as percentage change from the first-point Compliance measured. We will compare Compliance in PRVC to RVD in VCV ventilation. VCV is the reference point. | Perioperatory. |
| Measure | Description | Time Frame |
|---|---|---|
| Global Inhmogeneity Index (GI) | GI is a EIT-derived index to quantify the tidal volume distribution within the lung. We will compare GI in PRVC to RVD in VCV ventilation. VCV is the reference point. | Perioperatory. |
| Regional Ventilation Delay (RVD) |
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Inclusion Criteria:
Exclusion Criteria:
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Healthy pediatric patients undergoing general anesthesia requiring endotracheal intubation
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Vittore Buzzi Children's Hospital | Milan | 20154 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31409981 | Result | Kim YS, Won YJ, Lee DK, Lim BG, Kim H, Lee IO, Yun JH, Kong MH. Lung ultrasound score-based perioperative assessment of pressure-controlled ventilation-volume guaranteed or volume-controlled ventilation in geriatrics: a prospective randomized controlled trial. Clin Interv Aging. 2019 Jul 18;14:1319-1329. doi: 10.2147/CIA.S212334. eCollection 2019. | |
| 39369249 |
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RVD is an index of inhomogeneous ventilation. RVD quantifies the time difference between the onset of ventilation in different lung regions relative to a reference point. We will compare RVD in PRVC to RVD in VCV ventilation. VCV is the reference point.
| Perioperatory. |
| Camporesi A, Roveri G, Vetrugno L, Buonsenso D, De Giorgis V, Costanzo S, Pierucci UM, Pelizzo G. Lung ultrasound assessment of atelectasis following different anesthesia induction techniques in pediatric patients: a propensity score-matched, observational study. J Anesth Analg Crit Care. 2024 Oct 5;4(1):69. doi: 10.1186/s44158-024-00206-x. |
| 39649647 | Result | Wang Q, Li Y, Zhao K, Zhang J, Zhou J. Optimizing perioperative lung protection strategies for reducing postoperative respiratory complications in pediatric patients: a narrative review. Transl Pediatr. 2024 Nov 30;13(11):2043-2058. doi: 10.21037/tp-24-453. Epub 2024 Nov 26. |
| 36928465 | Result | Nascimento MS, Rebello CM, Costa ELV, Correa LC, Alcala GC, Rossi FS, Morais CCA, Laurenti E, Camara MC, Iasi M, Apezzato MLP, do Prado C, Amato MBP. Effect of general anesthesia and controlled mechanical ventilation on pulmonary ventilation distribution assessed by electrical impedance tomography in healthy children. PLoS One. 2023 Mar 16;18(3):e0283039. doi: 10.1371/journal.pone.0283039. eCollection 2023. |