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Optimal PEEP Level for Minimizing the Risk of Postoperative Atelectasis: A Retrospective Cohort Study Based on Lung Ultrasound Monitoring

Sponsored by State Budgetary Healthcare Institution, National Medical Surgical Center N.A. N.I. Pirogov, Ministry of Health of Russia

About this trial

Last updated 3 months ago

Study ID

NMSC-03-25

Status

Completed

Type

Observational

Placebo

No

Accepting

18+ Years
All Sexes

Trial Timing

Ended 3 months ago

What is this trial about?

Background: After surgery with general anesthesia, it is common for parts of the lungs to collapse, a condition called atelectasis. This can lead to low blood oxygen levels and other lung complications. Doctors use a setting on the breathing machine called PEEP (Positive End-Expiratory Pressure) to help keep the lungs open, but the best level to use is still debated. Purpose of the Study: The goal of this research is to find a PEEP level that minimizes the risk of lung collapse and low oxygen levels after surgery. The investigators will use lung ultrasound, a safe and non-invasive imaging method, to check the health of the lungs at the patient's bedside. The investigators will not assign treatments; they will observe the outcomes based on the PEEP level chosen by the patient's anesthesiologist during routine care. A simplified ultrasound scan will be used to score the amount of lung collapse before and after surgery. The main outcomes will be the frequency of lung collapse and the frequency of low oxygen levels (defined as SpO₂ of 90% or less).

What are the participation requirements?

Inclusion Criteria

* Patients undergoing surgical intervention under general anesthesia with mechanical ventilation.

* Airway protection managed with either an endotracheal tube or a laryngeal mask.

* A normal baseline ultrasound of the posterior-basal lung regions, corresponding to a score of 0 on the lung ultrasound scale.

Exclusion Criteria

* Patients undergoing cardiac or thoracic surgery.

* Presence of a perioperatively identified pneumothorax.

* Inability to obtain adequate ultrasound visualization of the target lung zones.

* Presence of hydrothorax.

* Confirmed perioperative pulmonary aspiration.

* Presence of any pathological findings on the initial baseline ultrasound of the posterior-basal lung regions.

* Requirement for massive blood transfusion during the operation.

* Patients undergoing surgery on the diaphragm.

* Prolonged residual sedation lasting more than 2 hours post-operation