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...
Autores principales: | , , , , , , , , |
---|---|
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 |
_version_ | 1782316802721710080 |
---|---|
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). |
format | Online Article Text |
id | pubmed-4026052 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT spiethpeterm variableversusconventionallungprotectivemechanicalventilationduringopenabdominalsurgerystudyprotocolforarandomizedcontrolledtrial AT guldnerandreas variableversusconventionallungprotectivemechanicalventilationduringopenabdominalsurgerystudyprotocolforarandomizedcontrolledtrial AT uhligchristopher variableversusconventionallungprotectivemechanicalventilationduringopenabdominalsurgerystudyprotocolforarandomizedcontrolledtrial AT bluththomas variableversusconventionallungprotectivemechanicalventilationduringopenabdominalsurgerystudyprotocolforarandomizedcontrolledtrial AT kissthomas variableversusconventionallungprotectivemechanicalventilationduringopenabdominalsurgerystudyprotocolforarandomizedcontrolledtrial AT schultzmarcusj variableversusconventionallungprotectivemechanicalventilationduringopenabdominalsurgerystudyprotocolforarandomizedcontrolledtrial AT pelosipaolo variableversusconventionallungprotectivemechanicalventilationduringopenabdominalsurgerystudyprotocolforarandomizedcontrolledtrial AT kochthea variableversusconventionallungprotectivemechanicalventilationduringopenabdominalsurgerystudyprotocolforarandomizedcontrolledtrial AT gamadeabreumarcelo variableversusconventionallungprotectivemechanicalventilationduringopenabdominalsurgerystudyprotocolforarandomizedcontrolledtrial |