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Trial registered on ANZCTR
Registration number
ACTRN12624000933550
Ethics application status
Approved
Date submitted
12/06/2024
Date registered
1/08/2024
Date last updated
1/08/2024
Date data sharing statement initially provided
1/08/2024
Date results provided
1/08/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
How Intra-Abdominal Insufflation Affects Mechanical Power in Various Body Positions?
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Scientific title
A Comparison of the Effect of Intra-abdominal Insufflation on Mechanical Power in Different Body Positions for Patients Undergoing Elective Laparoscopic Cholecystectomy
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Secondary ID [1]
312322
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none
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Universal Trial Number (UTN)
U1111-1309-1353
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Ventilator-associated lung injury
334076
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Condition category
Condition code
Anaesthesiology
330751
330751
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0
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Other anaesthesiology
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Surgery
330958
330958
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0
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Other surgery
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
We conducted a prospective observational study after ethics committee approval in patients over 18 years of age and American Society of Anesthesiologists (ASA) 1, 2, and 3 class patients undergoing elective laparoscopic cholecystectomy. All patients (n:60) included in the study were intubated and ventilated using a Drager Perseus A500 mechanical ventilator. All patients independent of the study are ventilated with this ventilator. The patients were ventilated in volume controlled ventilation (VCV) mode with a tidal volume of 7 ml/ kg, PEEP of 5 mmHg, I:E ratio of 1:2, respiratory rate of 12/min, fresh gas flow of 4 l/min, and FiO2 of 40%. Measurements were taken after hemodynamic stability was achieved. In 4 different conditions; the supine position pre-insufflation (Condition 1), the reverse Trendelenburg position 15º pre-insufflation (Condition 2), the supine position post-insufflation (Condition 3) and, the reverse Trendelenburg position 15º post-insufflation (Condition 4) peak pressure and hemodynamic data were recorded. The measurements of the patients were taken in the routine positions used during laparoscopic cholecystectomy operations. No non-routine positions were applied, and all patients independent of the study underwent surgery in this position. No interventional procedure was performed, and only observations were made during position changes. The patients were observed within 20 minutes after intubation. Mechanical power was calculated using predefined formula. Changes in 4 conditions were compared. The effect of obesity on mechanical power was investigated because it may affect compliance.
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Intervention code [1]
328796
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Not applicable
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Comparator / control treatment
Comparator: Supine pre-insufflation
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Control group
Active
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Outcomes
Primary outcome [1]
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Our composite primary outcome is to observe the change in mechanical power (MP) in different body positions before and after insufflation, as well as the change in MP of other positions compared to the initial position (supine pre-insufflation).
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Assessment method [1]
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In laparoscopic cholecystectomy surgery, the mechanical power that changes with intra-abdominal pressure and position is calculated by the formula (MP=(VE×(Ppeak+PEEP+F/6))/20), and the parameters in the formula are observed in the anesthesia machine and recorded at every stage.
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Timepoint [1]
338512
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After intubation within 20 minutes
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Secondary outcome [1]
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The effect of obesity on MP.
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Assessment method [1]
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Patients were classified according to body mass index. Those with BMI=29.9 (less than or equal to) were classified as non-obese group and those with BMI=30 (greater than or equal to) were classified as obese group and their differences were statistically analysed.
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Timepoint [1]
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Baseline (after intubation), 10 minutes before and within the first 10 minutes of surgery
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Eligibility
Key inclusion criteria
During the study period, patients over 18 years of age, ASA class 1, 2, and 3, who underwent elective laparoscopic cholecystectomy under general anaesthesia and non-depolarising neuromuscular blockade were included in the study.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(1) Patients under 18 years of age, (2) those who had undergone lung surgery, (3) those with advanced lung disease, (4) emergency surgery and (5) patients who did not accept the study were excluded.
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Sample size was calculated using G-Power version 3.0. With an effect size of 0.2, an alpha error of 5%, and a power of 95% the required sample size were calculated as 55 participants, and 60 participants were included in the study. Data were analysed using SPSS statistical software (version 23.0; SPSS Inc., Chicago, IL, USA). As the sample size was medium (n=60), the Z-value between -3.29 and +3.29 in the skewness and kurtosis evaluation was considered a normal distribution to test normality. (Kim, H. Y. (2013)). Data showing normal distribution were analysed using parametric tests, and data not showing normal distribution were analysed using non-parametric tests. Mechanical power data (within subjects) recorded before and after abdominal insufflation in two different body positions were tested by repeated measures mixed model ANOVA. The test was then repeated by adding obesity (between subjects) to the model. The homogeneity of variances for the differences between levels of repeated measures in the dataset was tested using Mauchly's test of sphericity. In cases where Mauchly's test of sphericity was statistically significant (p< .05), the Greenhouse-Geisser (GG) correction was applied as the assumption of sphericity was not met. Bonferroni correction was applied to reduce type 1 error in pairwise comparisons. P value < .05 was considered statistically significant in all tests.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/07/2022
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Date of last participant enrolment
Anticipated
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Actual
1/02/2023
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Date of last data collection
Anticipated
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Actual
1/02/2023
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Sample size
Target
60
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Accrual to date
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Final
60
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Recruitment outside Australia
Country [1]
26373
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Turkey
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State/province [1]
26373
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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S.B.Ü. Tepecik Training and Research Hospital
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Address [1]
316720
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Country [1]
316720
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Turkey
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Primary sponsor type
Hospital
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Name
S.B.Ü. Tepecik Training and Research Hospital
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Address
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Country
Turkey
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Secondary sponsor category [1]
318923
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None
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Name [1]
318923
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Address [1]
318923
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Country [1]
318923
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
315493
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Ethics Committee for Non-interventional Studies of S.B.Ü. Tepecik Training and Research Hospital
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Ethics committee address [1]
315493
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GÜNEY MAHALLESI 1140/1 SOKAK NO : 1 YENISEHIR - KONAK - IZMIR, TÜRKIYE
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Ethics committee country [1]
315493
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Turkey
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Date submitted for ethics approval [1]
315493
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02/05/2022
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Approval date [1]
315493
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15/06/2022
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Ethics approval number [1]
315493
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decision number 2022/06-14.
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Summary
Brief summary
The hypothesis of the study is that there is a change in mechanical power after insufflation in the reverse Trendelenburg position during laparoscopic cholecystectomy surgeries. The aim of the study is to investigate the effect of intra-abdominal insufflation on mechanical power and to measure the changes in mechanical power in different positions.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr BERNA SÖNMEZ
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Address
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Sivasli Government Hospital, Evrenli, Ugur Mumcu cad. No: 147, 64800, Sivasli, Usak
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Country
134870
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Turkey
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Phone
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+90 5363066011
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Fax
134870
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Email
134870
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[email protected]
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Contact person for public queries
Name
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BERNA SÖNMEZ
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Address
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Sivasli Government Hospital, Evrenli, Ugur Mumcu cad. No: 147, 64800, Sivasli, Usak
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Country
134871
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Turkey
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Phone
134871
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+90 5363066011
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Fax
134871
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Email
134871
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[email protected]
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Contact person for scientific queries
Name
134872
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BERNA SÖNMEZ
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Address
134872
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Sivasli Government Hospital, Evrenli, Ugur Mumcu cad. No: 147, 64800, Sivasli, Usak
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Country
134872
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Turkey
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Phone
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+90 5363066011
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Fax
134872
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Email
134872
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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