NCT01379313

The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing Gynecologic Laparoscopic Surgery With Trendelenburg Position

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 100 (actual)
• Sponsor: Samsung Medical Center · Academic / Other
• Sex: All
• Age: 20 Years – 65 Years
• Healthy volunteers: Not accepted

Summary

In patients undergoing gynecologic laparoscopic surgery with trendelenburg position, the disturbance of pulmonary gas exchange frequently occurs due to high intra-abdominal pressure. The investigators tried to evaluate the effect of various inspiratory to expiratory ratio on pulmonary gas exchange by randomized controlled trial.

Detailed description

In patients undergoing gynecologic laparoscopic surgery with trendelenburg position, the disturbance of pulmonary gas exchange frequently occurs due to high intra-abdominal pressure. During the laparoscopic surgery with abdominal gas insufflation, gas exchange disturbance such as CO2 retention, hypoxemia occurs in addition to high plateau airway pressure. The usual strategy against these kinds of problem is pressure-controlled ventilation. However, the gas exchange problem especially CO2 retention can not be solved in some cases. The inverse-ratio ventilation (IRV), which prolongs the inspiratory time greater than expiratory time, can be applied for adult respiratory distress syndrome. The efficacy of IRV is to improve gas-exchange status by increasing mean airway pressure and alveolar recruitment. There have been several clinical investigations which applied IRV during general anesthesia. However, there have been debates about the effect of IRV during general anesthesia. Therefore, we tried to apply the IRV for subjects undergoing laparoscopic surgery, and evaluate the effect of different I:E ratio on the pulmonary gas exchange and respiratory mechanics.

Conditions

• Uterine Myoma
• Ovarian Cyst
• Laparoscopic Gynecologic Surgery

Interventions

Type	Name	Description
PROCEDURE	conventional I:E ratio	conventional I:E ratio of 1:2 is applied.
PROCEDURE	1:1 ratio	I:E ratio of 1:1 is applied.
PROCEDURE	2:1 group	Inverse I:E ratio of 2:1 is applied.
PROCEDURE	external PEEP	external positive end-expiratory pressure of 5 cmH2O is applied.

Timeline

• Start date: 2011-06-01
• Primary completion: 2012-03-01
• Completion: 2012-03-01
• First posted: 2011-06-23
• Last updated: 2012-10-01

Locations

1 site across 1 country: South Korea