Impact of an Open Lung Extubation Strategy on Postoperative Pulmonary Complications
AnesthesiaPulmonary Atelectasis1 morePerioperative respiratory complications are a major source of morbidity and mortality. Postoperative atelectasis plays a central role in their development. Protective "open lung" mechanical ventilation aims to minimize the occurrence of atelectasis during the perioperative period. Randomized controlled studies have been performed comparing various "open lung" ventilation protocols, but these studies report varying and conflicting effects. The interpretation of these studies is complicated by the absence of imagery supporting the pulmonary impact associated with the use of different ventilation strategies. Imaging studies suggest that the gain in pulmonary gas content in "open lung" ventilation regimens disappears within minutes after the extubation. Thus, the potential benefits of open-lung ventilation appear to be lost if, at the time of extubation, no measures are used to keep the lungs well aerated. Recent expert recommendations on good mechanical ventilation practices in the operating room conclude that there is actually no quality study on extubation. Extubation is a very common practice for anesthesiologists as part of their daily clinical practice. It is therefore imperative to generate evidence on good clinical practice during anesthetic emergence in order to potentially identify an effective extubation strategy to reduce postoperative pulmonary complications.
Usage of High Flow Nasal Cannula in Preventing Desaturations in Elderly Patients Going for Lower...
Hypoxemia During SurgeryAtelectasisTo study the effect of high flow nasal cannula in comparisons with nasoprong used intraoperatively in patients oxygenation status
Ventilator-driven Alveolar Recruitment Maneuver
Postoperative AtelectasisVentilator Lung2 moreDuring laparoscopic surgery, gas infiltration and head down position cause pulmonary atelectasis. Alveolar recruitment maneuvers are beneficial in reopening collapsed alveoli and improving lung mechanics. Ventilator-driven Alveolar recruitment maneuvers may restore lung volume but it remains unknown which method is most effective. The primary aim was to compare the efficacy of two ventilator-driven ARMs method using incremental tidal volume or positive end expiratory pressure(PEEP) until plateau pressure 30 cmH20 (within driving pressure 20 cmH20).
The Digital Incentive Spirometer (DIS): Improving Adherence to Incentive Spirometry
Post-Op InfectionAdherence4 moreThe purpose of the protocol is to assess how incentive spirometer data gathered via a smartphone platform can be utilized to improve participant adherence to prescribed incentive spirometer exercises in the post-operative period. Half of the participants will receive a standard of care incentive spirometer with a passive tracking device while the other half of the participants will receive a smartphone connected device and smartphone with an application that will encourage their use.
Ventilation Strategy Reduces Postoperative Atelectasis
Pulmonary AtelectasisAtelectasis is common during and after general anesthesia. The investigators hypothesized that a ventilation strategy with a combination of 1) continuous positive airway pressure (CPAP) or positive end-expiratory pressure (PEEP) and 2) a reduced end-expiratory oxygen fraction (FETO2) before commencing mask ventilation with CPAP after extubation would reduce the area of postoperative atelectasis.
Prophylactic nCPAP Following Bowel Surgery (Bio-REB File 11-27)
Postoperative Pulmonary AtelectasisSurgeryThe purpose of this study is to determine whether prophylactic nasal continuous positive airway pressure (nCPAP) in the post-anaesthesia care unit (PACU) improves post-operative pulmonary function following elective bowel surgery. The investigators hypothesize that one hour of nCPAP in the PACU will result in a higher partial pressure of arterial oxygen (PaO2) when compared to the standard treatment of low flow oxygen applied by face mask.
Comparative Effectiveness of Unilateral vs. Bilateral Pulmonary Collapse in Cardiac De-airing
Brain IschemiaReduction of Cerebral Air EmboliTo compare the effectiveness of unilateral pulmonary collapse (right lung) to bilateral pulmonary collapse for cardiac de-airing in open left-sided heart surgery.
Evaluation of The MetaNeb® System to Reduce Postoperative Pulmonary Complications
AtelectasisPulmonary ComplicationsTo determine if a therapy regimen including treatment with The MetaNeb® System has a positive impact on the rate of pulmonary complications that occur in high risk post-operative patients. This is a non-randomized facility (or hospital) level pre-post intervention study.
Evaluation of the Effect of Lung Recruitment and Positive End- Expiratory Pressure (PEEP) on Anesthesia...
Anesthesia Induced AtelectasisAtelectasis is a side effect of general anesthesia which can be found in all types of interventions and patients of all ages.1-3 The reported incidence of anesthesia- induced atelectasis in children varies, ranging from 12 to 42% in sedated and nonintubated patients 5, 6 and from 68 to 100% in children with general anesthesia with tracheal intubation or laryngeal mask. The aim of this work is to evaluate the effect of lung recruitment on anesthesia induced atelectasis using intraoperative lung ultrasound. Objectives To determine the effect of recruitment on anesthesia induced atelectasis using lung ultrasound. To Estimate the change of Pao2 with anesthesia induced lung atelectasis. To Estimate the change of Pao2 with lung recruitment. To evaluate the feasibility of use of lung ultrasound as a tool to guide optimum lung recruitment.
Does High Intraoperative Inspired Oxygen Reduce Postoperative Arterial Oxygen Saturation?
AtelectasisThe purpose of this study is to determine whether breathing high levels of oxygen during surgery affects oxygen levels after surgery. The second purpose of this study is to determine whether giving positive end expiratory pressure PEEP and high oxygen together affects patients oxygen levels after surgery.