Comparing Innovative and Traditional Ventilation Strategies on Atelectasis and Prognosis in Elderly Patients
Ventilator-associated Lung Injury, Atelectasis, Postoperative Pulmonary Complications
About this trial
This is an interventional prevention trial for Ventilator-associated Lung Injury focused on measuring perioperative strategies for lung-protective ventilation, elderly patients, atelectasis, postoperative pulmonary complications, lung injury
Eligibility Criteria
Inclusion Criteria: Elderly patients aged ≥ 60 years old who undergo laparoscopic abdominal surgery; Body mass index(BMI) <30; American society of anesthesiologists physical status classification system(ASA):I-III; When the patient inhales air before surgery, SPO2≥94%; The duration of the operation is 2-7 hours, and the pneumoperitoneal pressure is 10-14mmHg. Exclusion Criteria: Patients with acute respiratory distress syndrome or pulmonary hypertension (pulmonary systolic blood pressure ≥ 40mmHg) or bronchiectasis or lung malignant tumors Patients with acute respiratory infections within one month before surgery Patients who have undergone cardiopulmonary surgery Receiving invasive mechanical ventilation for more than 30min within 30 days before surgery Patients with peak airway pressure > 35 cm H2O during intraoperative mechanical ventilation Patients with severe organic lesions of the heart such as obvious heart failure and coronary heart disease Patients with preoperative anemia (Hb<10g/L) Patients with hypoproteinemia before surgery (albumin < 35 g/L) Patients with tracheostomy and severe difficult airway Patients with sleep apnea syndrome Patients with intraoperative heavy bleeding (50% of the circulating blood volume is lost ≥ 3 hours) Patients with mental illness, impaired consciousness and communication disorders Patients who refuse to participate in this trial
Sites / Locations
- Fujian Medical University Union HospitalRecruiting
- The First Hospital of Putian
- The First Affiliated Hospital of Nanchang UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Arm 8
Sham Comparator
Experimental
Experimental
Experimental
Sham Comparator
Experimental
Experimental
Experimental
Group of Control (Part I experiment)
Group of traditional lung-protective ventilation (Part I experiment)
Group of innovative lung-protective ventilation (Part I experiment)
Group of traditional & innovative ventilation (Part I experiment)
Group of Control (Part II experiment)
Group of positive pressure extubation (Part II experiment)
Group of breathing training (Part II experiment)
Group of positive pressure extubation & breathing training (Part II experiment)
Traditional ventilation strategies
Traditional lung-protective ventilation strategies
Innovative lung-protective ventilation strategies
Traditional & innovative lung protection ventilation strategies
lung-protective ventilation; negative pressure extubation
lung-protective ventilation; positive pressure extubation
lung-protective ventilation; negative pressure extubation; postoperative breathing training
lung-protective ventilation; positive pressure extubation; postoperative breathing training