Individualized Perioperative Open-lung Ventilatory Strategy With High Versus Conventional Inspiratory Oxygen Fraction (iPROVE-O2). (iPROVE-O2)
Hyperoxia, Postoperative Complication, Surgical Site Infection
About this trial
This is an interventional prevention trial for Hyperoxia focused on measuring Oxygen, surgical site infection, postoperative complication, recruitment maneuvers, open lung strategy
Eligibility Criteria
Inclusion Criteria:
- Age not less than 18
- Planned abdominal surgery> 2 hours.
- Signed informed consent for participation in the study.
Exclusion Criteria:
- Age less than 18 years.
- Pregnant or breast-feeding.
- Patients with BMI >35.
- Syndrome of moderate or severe respiratory distress: PaO2/FiO2 < 200 mmHg.
- Heart failure: NYHA IV.
- Hemodynamic failure: CI <2.5 L/min/m2 and / or requirements before surgery ionotropic support.
- Diagnosis or suspicion of intracranial hypertension (intracranial pressure> 15 mmHg).
- Mechanical ventilation in the last 15 days.
- Presence of pneumothorax. Presence of giant bullae on chest radiography or computed tomography (CT).
- Patient with preoperatively CPAP.
- Participation in another experimental protocol at the time of intervention selection.
Sites / Locations
- Department of Anesthesia and Critical Care; Hospital Clinico UniversitarioRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
High FiO2
Conventional FiO2
Intraoperatively ventilated patients with a tidal volume (VT) of 8 ml / kg of ideal body weight, and a FiO2 of 0.8. After intubation, all patients were conduct an alveolar recruitment maneuver (MRA) and PEEP level individualized spanned (see Calculation of optimal PEEP). Every 40 minutes will be assessed the need to adjust the level of PEEP by evaluating the dynamic compliance of the respiratory system (Crs). Faced with a decline in Crs> 10% a new MRA and optimal PEEP setting will be assessed. Postoperatively 3h with 0.8 FiO2 and individualized CPAP
Intraoperatively ventilated patients with a tidal volume (VT) of 8 ml / kg of ideal body weight, and a FiO2 of 0.3. After intubation, all patients were conduct an alveolar recruitment maneuver (MRA) and PEEP level individualized spanned (see Calculation of optimal PEEP). Every 40 minutes will be assessed the need to adjust the level of PEEP by evaluating the dynamic compliance of the respiratory system (Crs). Faced with a decline in Crs> 10% a new MRA and optimal PEEP setting will be assessed. Postoperatively 3h with 0.3 FiO2 and individualized CPAP