An interventional study of mechanical ventilation modes in Cholecystitis; Gallstone, Mechanical Ventilation Pressure High and Intraabdominal Hypertension, sponsored by Sisli Hamidiye Etfal Training and Research Hospital. Completed at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2021-10-14.
Sponsored by Sisli Hamidiye Etfal Training and Research Hospital · Not applicable, Interventional, and Screening
In laparoscopic cholecystectomy method, Insufflation of CO2 in abdominal cavity causes positioning of the diaphragm upwards, a decrease in lung's volume and its compliance, an increase in the airway resistance, mismatch between the atelectasis and the ventilation perfusion. Although there are numerous studies in laparoscopic surgery, only a few of them investigate the effects of laparoscopic surgery on the cardiopulmonary and the respiratory mechanics. The investigator aimed To examine the effects of pressure-controlled and volume-controlled ventilation modes on cerebral oximetry and blood gases in laparoscopic cholecystectomy operations.
Since the laparoscopic methods have been introduced to the surgical operations, laparoscopic cholecystectomy has become the golden standard in gall bladder surgical treatments. In this method, carbon dioxide (CO2) pneumoperitoneum method is used to achieve the desired surgical and visual conditions. Alongside the advantages of the Laparoscopic cholecystectomy method (e.g. shortening the patient's length of stay at the hospital, minimal postoperative pain and rapid recovery), it has various intraabdominal pressure related systemic disadvantages . Insufflation of CO2 in abdominal cavity causes positioning of the diaphragm upwards, a decrease in lung's volume and its compliance, an increase in the airway resistance, mismatch between the atelectasis and the ventilation perfusion. Various ventilation strategies have been introduced to increase arterial oxygenation, functional residual capacity (FRC), and the lung compliance. Recent studies; demonstrates that pressure-controlled mechanical ventilation is superior to volume-controlled mechanical ventilation in providing arterial and tissue oxygenation.
Although there are numerous studies in laparoscopic surgery, only a few of them investigate the effects of laparoscopic surgery on the cardiopulmonary and the respiratory mechanics. Several experimental and clinical studies describe that the cardiovascular effects of the high intraabdominal pressure and the CO2 insufflation is complex. In fact, the results are linked to the studied patients' population, the lung's position and its volume. As it is known in laparoscopic surgeries, the oxygenation in cerebral tissue decreases as the intraabdominal pressure increases. At present, bispectral index (BIS), electroencephalography (EEG), auditory evoke potential (AEP) (and several others) and functional NIRS (fNIRS) are used to measure cerebral oxygenation and anaesthetic depth. NIRS monitorisation makes use of the combined effects of the transmission, the reflection, the dispersion, and the absorption of light. It can also measure the oxygen saturation in tissues that does not have pulsatile circulation. The investigator aimed To examine the effects of pressure-controlled and volume-controlled ventilation modes on cerebral oximetry and blood gases in laparoscopic cholecystectomy operations.
272 studies on the registry are indexed under Cholecystitis; 46 are open to participants now.
This study's enrollment of 70 is below the median of 87 across 172 interventional studies indexed under Cholecystitis.
Browse Cholecystitis studies →Sisli Hamidiye Etfal Training and Research Hospital is the lead sponsor of 113 studies on the registry; 16 are open to participants now.
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Exclusion Criteria:
patients will ventilate with volume controlled mode
Device: mechanical ventilation modes
patients will ventilate with pressure controlled mode
Device: mechanical ventilation modes
ventilation with pressure controlled mode in laparoscopic abdominal surgery ventilation with volume controlled mode in laparoscopic abdominal surgery
NIRS
near infrared reflectance spectroscopy values recorded at before the anesthesia, after intubation, before and after deflation
Time frame: 0 to 3 hours (approximately)
oxygen saturation
oxygen saturation with pulse-oximeter at before the anesthesia, after intubation, before and after deflation
Time frame: 0 to 3 hours (approximately)
end-tidal carbon dioxide
end-tidal carbon dioxide with mechanical ventilator at before the anesthesia, after intubation, before and after deflation
Time frame: 0 to 3 hours (approximately)
partial oxygen pressure
partial oxygen pressure in blood gases at before the anesthesia, after intubation, before and after deflation
Time frame: 0 to 3 hours (approximately)
P peak
peak pressure in mechanical ventilation mod at before the anesthesia, after intubation, before and after deflation
Time frame: 0 to 3 hours (approximately)
Plan to share: No
This study is completed, as verified in Oct 2021. You cannot join it, but the record below documents what was studied.
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