Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial

BACKGROUND: General anesthesia usually requires mechanical ventilation, which is traditionally accomplished with constant tidal volumes in volume- or pressure-controlled modes. Experimental studies suggest that the use of variable tidal volumes (variable ventilation) recruits lung tissue, improves p...

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Autores principales: Spieth, Peter M, Güldner, Andreas, Uhlig, Christopher, Bluth, Thomas, Kiss, Thomas, Schultz, Marcus J, Pelosi, Paolo, Koch, Thea, Gama de Abreu, Marcelo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026052/
https://www.ncbi.nlm.nih.gov/pubmed/24885921
http://dx.doi.org/10.1186/1745-6215-15-155
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author Spieth, Peter M
Güldner, Andreas
Uhlig, Christopher
Bluth, Thomas
Kiss, Thomas
Schultz, Marcus J
Pelosi, Paolo
Koch, Thea
Gama de Abreu, Marcelo
author_facet Spieth, Peter M
Güldner, Andreas
Uhlig, Christopher
Bluth, Thomas
Kiss, Thomas
Schultz, Marcus J
Pelosi, Paolo
Koch, Thea
Gama de Abreu, Marcelo
author_sort Spieth, Peter M
collection PubMed
description BACKGROUND: General anesthesia usually requires mechanical ventilation, which is traditionally accomplished with constant tidal volumes in volume- or pressure-controlled modes. Experimental studies suggest that the use of variable tidal volumes (variable ventilation) recruits lung tissue, improves pulmonary function and reduces systemic inflammatory response. However, it is currently not known whether patients undergoing open abdominal surgery might benefit from intraoperative variable ventilation. METHODS/DESIGN: The PROtective VARiable ventilation trial (‘PROVAR’) is a single center, randomized controlled trial enrolling 50 patients who are planning for open abdominal surgery expected to last longer than 3 hours. PROVAR compares conventional (non-variable) lung protective ventilation (CV) with variable lung protective ventilation (VV) regarding pulmonary function and inflammatory response. The primary endpoint of the study is the forced vital capacity on the first postoperative day. Secondary endpoints include further lung function tests, plasma cytokine levels, spatial distribution of ventilation assessed by means of electrical impedance tomography and postoperative pulmonary complications. DISCUSSION: We hypothesize that VV improves lung function and reduces systemic inflammatory response compared to CV in patients receiving mechanical ventilation during general anesthesia for open abdominal surgery longer than 3 hours. PROVAR is the first randomized controlled trial aiming at intra- and postoperative effects of VV on lung function. This study may help to define the role of VV during general anesthesia requiring mechanical ventilation. TRIAL REGISTRATION: Clinicaltrials.gov NCT01683578 (registered on September 3 3012).
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spelling pubmed-40260522014-05-20 Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial Spieth, Peter M Güldner, Andreas Uhlig, Christopher Bluth, Thomas Kiss, Thomas Schultz, Marcus J Pelosi, Paolo Koch, Thea Gama de Abreu, Marcelo Trials Study Protocol BACKGROUND: General anesthesia usually requires mechanical ventilation, which is traditionally accomplished with constant tidal volumes in volume- or pressure-controlled modes. Experimental studies suggest that the use of variable tidal volumes (variable ventilation) recruits lung tissue, improves pulmonary function and reduces systemic inflammatory response. However, it is currently not known whether patients undergoing open abdominal surgery might benefit from intraoperative variable ventilation. METHODS/DESIGN: The PROtective VARiable ventilation trial (‘PROVAR’) is a single center, randomized controlled trial enrolling 50 patients who are planning for open abdominal surgery expected to last longer than 3 hours. PROVAR compares conventional (non-variable) lung protective ventilation (CV) with variable lung protective ventilation (VV) regarding pulmonary function and inflammatory response. The primary endpoint of the study is the forced vital capacity on the first postoperative day. Secondary endpoints include further lung function tests, plasma cytokine levels, spatial distribution of ventilation assessed by means of electrical impedance tomography and postoperative pulmonary complications. DISCUSSION: We hypothesize that VV improves lung function and reduces systemic inflammatory response compared to CV in patients receiving mechanical ventilation during general anesthesia for open abdominal surgery longer than 3 hours. PROVAR is the first randomized controlled trial aiming at intra- and postoperative effects of VV on lung function. This study may help to define the role of VV during general anesthesia requiring mechanical ventilation. TRIAL REGISTRATION: Clinicaltrials.gov NCT01683578 (registered on September 3 3012). BioMed Central 2014-05-02 /pmc/articles/PMC4026052/ /pubmed/24885921 http://dx.doi.org/10.1186/1745-6215-15-155 Text en Copyright © 2014 Spieth et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Study Protocol
Spieth, Peter M
Güldner, Andreas
Uhlig, Christopher
Bluth, Thomas
Kiss, Thomas
Schultz, Marcus J
Pelosi, Paolo
Koch, Thea
Gama de Abreu, Marcelo
Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial
title Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial
title_full Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial
title_fullStr Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial
title_full_unstemmed Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial
title_short Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial
title_sort variable versus conventional lung protective mechanical ventilation during open abdominal surgery: study protocol for a randomized controlled trial
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026052/
https://www.ncbi.nlm.nih.gov/pubmed/24885921
http://dx.doi.org/10.1186/1745-6215-15-155
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