Effects of Different Inhalation Oxygen Concentrations on Postoperative Atelectasis (DIOCA)
Atelectasis
About this trial
This is an interventional treatment trial for Atelectasis
Eligibility Criteria
Inclusion Criteria: patients with American Society of Anesthesiologist (ASA) physical status I-II; Older than 18 years; Patients with operation time more than 2 hours and plan to extubate in the operating room; Preoperative blood gas partial pressure of oxygen was more than 80mmHg; Patients scheduled for elective neurosurgery were operated in the supine position. Exclusion Criteria: A history of acute lung injury with acute respiratory distress syndrome within three months; Heart failure (New York Heart Association class) greater than IV, severe liver and kidney dysfunction (Child B or C liver failure, glomerular filtration rate <30ml/min); BMI > 30 kg/m2. The operation time is more than 10 hours; The amount of bleeding was more than 500ml; The total fluid volume exceeded 3000ml.
Sites / Locations
- the First Hospital of China Medical UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Experimental: 30% Oxygen
Placebo Comparator: 60% Oxygen
Before anesthesia induction, the participants inhaled pure oxygen through the mask for 5 mins. After successful anesthesia induction, Fio2 will be adjusted to 30%, and the total gas flow rate will be set at 2L/min. All patients will be performed via the lung protective ventilation strategy. The respiratory parameters are VT: 6-8ml/kg, PEEP: 6-8 cmh2O, RR: 1:2, and respiratory rate will be adjusted by maintaining a partial pressure of carbon dioxide at 35-45 mmHg. Manual lung recruitment maneuvers will be performed after tracheal intubation and before tracheal extubation, however when intraoperative oxygen saturation is less than 92% the manual lung recruitment maneuver will be done too. Arterial blood will be collected twice for blood gas analysis, the first once is in the non-oxygen inhalation state before anesthesia induction and the second is 30min before the end of surgery. Patients in both groups will be extubated in the operating room and then sent to the PACU.
Before anesthesia induction, the participants inhaled pure oxygen through the mask for 5 mins. After successful anesthesia induction, Fio2 will be adjusted to 60%, and the total gas flow rate will be set at 2L/min. All patients will be performed via the lung protective ventilation strategy. The respiratory parameters are VT: 6-8ml/kg, PEEP: 6-8 cmh2O, RR: 1:2, and respiratory rate will be adjusted by maintaining a partial pressure of carbon dioxide at 35-45 mmHg. Arterial blood will be collected twice for blood gas analysis, the first once is in the non-oxygen inhalation state before anesthesia induction and the second is 30min before the end of surgery. Patients in both groups will be extubated in the operating room and then sent to the PACU.