Detecting Lung's Closing Pressure by Capnography

NCT05873998 | Completed DMC

• 1 other identifier: CP2023
• Study Type: observational
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

General anesthesia is associated with loss of pulmonary functional residual capacity and the consequent development of atelectasis and closure of the small airway. Mechanical ventilation in a lung with reduced functional residual capacity and atelectasis increased the dynamic alveolar stress-strain, inducing a local inflammatory response in atelectatic lung areas known as ventilatory-induced lung injury. This phenomenon may appear even in healthy patients undergoing general anesthesia and predisposes them to hypoxemic episodes that can persist in the early postoperative period. Lung recruitment maneuvers restore the functional residual capacity and, therefore, protect the lungs from lung injury. A key issue in this kind of treatment is detecting the lung's closing pressure in order to maintain the end-expiratory pressure above such a limit.

Conditions

Atelectasis

Keywords

carbon dioxide; mechanical ventilation

Outcome Measures

Primary Outcomes (2)

• Airway pressure

  Airway pressure will be measured at the airways opening and expressed in cmH2O.

  30 minutes

• Carbon dioxide

  Expired carbon dioxide will be measured at the airways opening by a main-stream capnograph, expressed in mmHg.

  30 minutes

Study Arms (1)

Adults anesthetized patients undergoing mediastinoscopy

Determination of the lung's closing pressure by pressure-CO2 and volume-CO2 curves using a slow pressure-volume curve after anesthesia induction. Later on, a standard lung recruitment maneuver followed by a positive end-expiratory pressure trial was done to detect the lung's closing pressure.

Diagnostic Test: Slow pressure-volume curve

Interventions

Slow pressure-volume curve DIAGNOSTIC_TEST

Patients will be sequentially subjected to a slow pressure-volume curve and a lung recruitment maneuver

Also known as: Lung recruitment maneuver

Adults anesthetized patients undergoing mediastinoscopy

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients undergoing general anesthesia for mediastinoscopy.

You may qualify if:

• Age \> 17 years ole
• Programmed surgery

You may not qualify if:

• Pregnancy
• No programmed surgery
• Hemodynamic instability
• Severe COPD
• Acute respiratory infection

Sponsors & Collaborators

• Hospital Privado de Comunidad de Mar del Plata: lead

Study Sites (1)

Hospital Privado de Comunidad

Mar del Plata, Buenos Aires, 7600, Argentina

Location

MeSH Terms

Conditions

Pulmonary Atelectasis

Condition Hierarchy (Ancestors)

Lung Diseases; Respiratory Tract Diseases

Study Officials

• Nora Fuentes, PhD

  Hospital Privado de Comunidad

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 28, 2023
• First Posted: May 24, 2023
• Study Start: February 28, 2023
• Primary Completion: May 1, 2025
• Study Completion: May 10, 2025
• Last Updated: May 16, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

AR (1)