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Practice pattern study of fluids given during abdominal cancer surgeries

ABSTRACT: Intervention1: NA: NA Control Intervention1: NA: NA Primary outcome(s): Amount of crystalloids and colloids administered during intraoperative period in major elective GI surgeries.Timepoint: Amount of crystalloids and colloids measured at the end of surgery.

DISEASE(S): Malignant Neoplasm Of Rectum,Malignant Neoplasm Of Rectosigmoidjunction,Malignant Neoplasm Of Colon, Unspecified,Malignant Neoplasm Of Anus, Unspecified,Malignant Neoplasm Of Gallbladder,Malignant Neoplasm Of Small Intestine, Unspecified,Malignant Neoplasm Of Stomach, Unspecified,Malignant Neoplasm Of Intestinal Tract, Part Unspecified,Malignant Neoplasm Of Pancreas, Unspecified

PROVIDER: 57391 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:BackgroundPneumoperitoneum and Trendelenburg position in laparoscopic surgeries could contribute to postoperative pulmonary dysfunction. In recent years, intraoperative lung-protective mechanical ventilation (LPV) has been reportedly able to attenuate ventilator-induced lung injuries (VILI). Our objectives were to test the hypothesis that LPV could improve intraoperative oxygenation function, pulmonary mechanics and early postoperative atelectasis in laparoscopic surgeries.MethodsIn this randomized controlled clinical trial, 62 patients indicated for elective abdominal laparoscopic surgeries with an expected duration of greater than 2 h were randomly assigned to receive either lung-protective ventilation (LPV) with a tidal volume (Vt) of 7 ml kg- 1 ideal body weight (IBW), 10 cmH2O positive end-expiratory pressure (PEEP) combined with regular recruitment maneuvers (RMs) or conventional ventilation (CV) with a Vt of 10 ml kg- 1 IBW, 0 cmH2O in PEEP and no RMs. The primary endpoints were the changes in the ratio of PaO2 to FiO2 (P/F). The secondary endpoints were the differences between the two groups in PaO2, alveolar-arterial oxygen gradient (A-aO2), intraoperative pulmonary mechanics and the incidence of atelectasis detected on chest x-ray on the first postoperative day.ResultsIn comparison to CV group, the intraoperative P/F and PaO2 in LPV group were significantly higher while the intraoperative A-aO2 was clearly lower. Cdyn and Cstat at all the intraoperative time points in LPV group were significantly higher compared to CV group (p < 0.05). There were no differences in the incidence of atelectasis on day one after surgery between the two groups.ConclusionsLung protective mechanical ventilation significantly improved intraoperative pulmonary oxygenation function and pulmonary compliance in patients experiencing various abdominal laparoscopic surgeries, but it could not ameliorate early postoperative atelectasis and oxygenation function on the first day after surgery.Trial registrationhttps://www.clinicaltrials.gov/identifier: NCT04546932 (09/05/2020).

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Practice pattern study of fluids given during abdominal cancer surgeries

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