Minimizing Lung Injury During Laparoscopy in Steep Trendelenburg Position

Summary

The investigators hypothesize that the level of PEEP is often suboptimally applied in certain operative conditions, such as in laparoscopy with head down (Trendelenburg) positioning. This can result in excessive levels of lung stress and postoperative pulmonary complications.

In patients with steep Trendelenburg and a pneumoperitoneum, the investigators aim to

1. measure apical versus basal atelectasis using the lung ultrasound score
2. compare lung ultrasound scores at different PEEP levels
3. compare respiratory mechanics at the different PEEP levels
4. contrast the optimal PEEP level to standard practice
5. provide guidance to optimal PEEP titration in this setting for the clinician

Conditions

• Atelectasis

Interventions

PROCEDURE

Decremental PEEP

High PEEP to low PEEP.

DIAGNOSTIC_TEST

Lung ultrasound score

lung ultrasound to determine the extend of atelectasis. Uses validated lung ultrasound score.

DIAGNOSTIC_TEST

Blood gas analysis

Blood gas analysis to determine arterial oxygen tension

DIAGNOSTIC_TEST

Registration of respiratory mechanics

Pressures and volumes will be registered by the Fluxmed respiratory monitor (MBMED, Argentina)

DIAGNOSTIC_TEST

Evaluation of dead space

Dead space will be measured non-invasively using volumetric capnography on the FluxMed respiratory monitor (MBMED, Argentina)

Sponsors & Collaborators

• University Hospital, Antwerp

  lead OTHER

Principal Investigators

• Vera Saldien, MD, PhD · Head of the department of anesthesiology

• Tom Schepens, MD, PhD · Anesthetist/intensivist

• Gregory De Meyer, MD · Anesthetist in training

• Stuart G Morrison, MD · Staff anesthetist

Study Design

Allocation

NA

Purpose

PREVENTION

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Max Age

80 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2021-06-21

Primary Completion

2021-09-23

Completion

2021-09-23

Countries

• Belgium

Study Locations