<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03009331</url>
  </required_header>
  <id_info>
    <org_study_id>AMartinssonthorax</org_study_id>
    <nct_id>NCT03009331</nct_id>
  </id_info>
  <brief_title>Descriptive and Comparative Study of Respiratory Function in the Postoperative Cardiac Surgery Patient</brief_title>
  <official_title>Descriptive and Comparative Study of Respiratory Function in the Postoperative Cardiac Surgery Patient</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Sahlgrenska University Hospital, Sweden</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Sahlgrenska University Hospital, Sweden</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The study comprises two different objectives. Longitudinal description of postoperative&#xD;
      pulmonary dysfunction in the cardiothoracic surgery patient, and the comparison of two&#xD;
      different lungrecruitment strategies.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Introduction:&#xD;
&#xD;
      Atelectasis and consolidation of lung tissue is a well recognized clinical scenario following&#xD;
      anaesthesia, musclerelaxation and mechanical ventilation. In cardiac surgery during&#xD;
      cardiopulmonary bypass (CPB), the lungs are collapsed to a degree depending on surgical&#xD;
      opening of the pleura, time on bypass, and gasmixture on termination of ventilation.&#xD;
      Recruitment of the lungs on commencement of mechanical ventilation after CPB generally must&#xD;
      be repeated before extubation. There are several different approaches to Recruitment&#xD;
      Manoeuvers (RM). Increasing pressures in the ventilator (peak-pressures and PEEP), increasing&#xD;
      tidal volumes and inspiratory hold are facilities offered by the ventilator. Different body&#xD;
      positions by interaction of the abdomen and thorax through the diaphragm, and the action of&#xD;
      gravity on the lungs and adjoining organs, are other principles. The contribution of&#xD;
      spontaneous ventilatory efforts also play a major roll.&#xD;
&#xD;
      Study rationale:&#xD;
&#xD;
      The study comprises two different objectives. Longitudinal description of postoperative&#xD;
      pulmonary dysfunction in the cardiothoracic surgery patient, and the comparison of two&#xD;
      different lungrecruitment strategies.&#xD;
&#xD;
      All patients undergoing cardiothoracic surgery develops some degree of postoperative&#xD;
      pulmonary dysfunction (PPD), including hypoxemia, increased work of breathing, shallow&#xD;
      respiration and ineffective cough. Respiratory symptoms of larger clinical significance are&#xD;
      better investigated, known as postoperative pulmonary complications (PPC), including pleural&#xD;
      effusion, atelectasis, pneumonia and ARDS. Pathophysiology is complex and multifactorial, and&#xD;
      there is a continuum between PPD and PPC that has not yet been well explored. A large&#xD;
      proportion of patients readmitted to CICU present respiratory failure, significantly&#xD;
      accounting for morbidity, mortality, and costs.&#xD;
&#xD;
      Regarding lungrecruitment, supine position is compared to modified prone position with&#xD;
      similar ventilator settings. Initial measurements preoperatively in the awake patient, then&#xD;
      during sedation and ventilator treatment, followed up by measurements before discharge from&#xD;
      the surgical ward on postoperative day 4-5.&#xD;
&#xD;
      Effect of RM is evaluated from ventilator measurement of compliance (C), arterial oxygenation&#xD;
      and P/F-ratio from the arterial blood gas (ABG), and electrical impedance tomography (EIT).&#xD;
      EIT measures the impedance of a thoracic sagittal section by emitting and sampling electrical&#xD;
      currents between 16 electrodes fixed on a submamillar belt. Radiology report from routine&#xD;
      chest X-ray and ultrasonography of the lungs and pleura will be added.&#xD;
&#xD;
      Should RM in prone position prove to be more efficient, postoperative complications in terms&#xD;
      of respiratory failure and pneumonia could be reduced, facilitating postoperative recovery&#xD;
      and shortening convalescens. This would justify the increased burden of care in the cardiac&#xD;
      ICU.&#xD;
&#xD;
      Study objectives:&#xD;
&#xD;
      The study aims to compare lung recruitment in two different body positions, supine (elevated&#xD;
      30 degrees) to left modified prone position (left side up, 120 degrees). Parameters&#xD;
      investigated are global and regional pulmonary impedance (EIT), lungcompliance, and arterial&#xD;
      oxygenation. Chest X-ray and lung ultrasound will be performed for additional analyses.&#xD;
&#xD;
      A descriptive longitudinal study of the 20 patients lungrecruited in supine position will&#xD;
      also be performed.&#xD;
&#xD;
      Study design:&#xD;
&#xD;
      Prospective, randomized clinical trial. Two groups with 20 cardiac surgery patients in each.&#xD;
&#xD;
      Study procedure:&#xD;
&#xD;
      Protocol&#xD;
&#xD;
      Day -1:&#xD;
&#xD;
      1 day preop. EIT measurement in supine (30 degrees elevated) and modified left prone position&#xD;
      (left side up, 120 degrees). Two measurements of each 2 min duration in both positions. ABG&#xD;
      is performed after breathing through a Venturi-mask delivering FiO2 0.5 for 10 minutes.&#xD;
      Randomization to either of the two groups.&#xD;
&#xD;
      Day 0:&#xD;
&#xD;
      Day of surgery. Standard periop care in coherence with department routines. Preoxygenation&#xD;
      using FiO2 1.0 during induction of anaesthesia, and before commencing cardiopulmonary bypass&#xD;
      (CPB). Inhalational anaesthetics during surgical preparation, and again after weaning from&#xD;
      CPB. Apnoea without PEEP or intermittent ventilation during CPB. Before weaning from CPB&#xD;
      manual lung recruitment with the APL-valve set to 30 cm H2O, and visual guidance of the&#xD;
      lungparenchyma or pleura. After chest closure, FiO2 is set to 0.5, volume controlled&#xD;
      ventilation 4-6 ml/Kg titrated according to pCO2, and PEEP is set to 5 cm H2O. Patient&#xD;
      ventilation circuit will be broken twice in conjugation with the use of a transport&#xD;
      ventilator device before arrival in the CICU. Ventilator settings in the CICU is&#xD;
      pressure-regulated volume-controlled ventilation (VKTS), tidal volumes of 4-6 ml/Kg titrated&#xD;
      according to pCO2, respiratory frequency of 14/min, and PEEP 8 cm H2O.&#xD;
&#xD;
      Recruitment maneuver (RM) is performed within 10 min on arrival in the CICU. Patient must be&#xD;
      stabile in hemodynamic parameters, including volume status. PEEP is set to 20 cm H2O,&#xD;
      pressure controlled ventilation with peak pressure 40 cm H2O for 30 s (5 inspirations),&#xD;
      thereafter PEEP-trial starting from 15 cm H2O for optimal PEEP using the &quot;Open Lung Tool&quot;&#xD;
      (Maquet Flow-i software). During the PEEP-trial, VKTS for tidal volumes of 6 ml/Kg is used.&#xD;
&#xD;
      Supine position group: RM in supine position. EIT, ABG and lung compliance measurements in&#xD;
      supine position before RM (30 degrees elevation), then immediately and 30 min after RM, and&#xD;
      again 30 minutes after extubation. FiO2 0.5 at all ABG measuring points.&#xD;
&#xD;
      Modified prone position group: RM in modified prone position (120 degrees, left side up).&#xD;
      EIT, ABG and lung compliance measurements in supine position before RM (30 degrees&#xD;
      elevation), and then immediately after RM when turned back to supine position (30 degrees&#xD;
      elevation), and 30 minutes after RM. Finally, measurements 30 minutes after extubation. FiO2&#xD;
      0.5 at all ABG measuring points.&#xD;
&#xD;
      Day 4-5:&#xD;
&#xD;
      Supine and prone position groups: EIT in supine position (30 degrees elevation) and ABG&#xD;
      repeated at day 4-5 postop. ABG is performed after breathing through a Venturi-mask&#xD;
      delivering FiO2 0.5 for 10 minutes. Ultrasonography of the pleurae. Chest-X-ray performed&#xD;
      routinely on the day after chest-drain removal.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Active, not recruiting</overall_status>
  <start_date type="Actual">July 25, 2017</start_date>
  <completion_date type="Anticipated">August 25, 2022</completion_date>
  <primary_completion_date type="Actual">April 25, 2019</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Supportive Care</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Electrical impedance</measure>
    <time_frame>5 days</time_frame>
    <description>Electrical impedance tomography, thoracical transverse plane measurment. Dräger Pulmovista device is used for collecting the data. Data will be transferred to a personal computer, and processed in Excel.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Lungcompliance (ml/cm H2O)</measure>
    <time_frame>2 hours</time_frame>
    <description>Pulmonary dynamic compliance, ventilator measurment.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>P/F ratio</measure>
    <time_frame>5 days</time_frame>
    <description>Oxygenation ratio, pO2 divided by FiO2, indication of pulmonary shunt</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Ultrasonography</measure>
    <time_frame>5 days</time_frame>
    <description>Lungultrasound to exclude pleural effusion.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Chest X-ray</measure>
    <time_frame>5 days</time_frame>
    <description>Chest X-ray to exclude pneumothorax</description>
  </primary_outcome>
  <other_outcome>
    <measure>Safety and Tolerability of prone position (turned 180 dgrees from supine position, Intensive Care Unit Bed), number of adverse events observed by the primary investigator.</measure>
    <time_frame>2 hours</time_frame>
    <description>Placing a patient in prone position in the immediate postoperative and sedated setting in the Cardiac Intensive Care Unit. Adverse events will be observed and noted by the primary investigator. Adverse events will be divided in less severe (e.g disruption of monitoring, uncoupling of breathing curcuit) and severe (e.g accidental extubation, decubitus ulcers, emergency return to supine position).</description>
  </other_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">30</enrollment>
  <condition>Pulmonary Atelectasis</condition>
  <arm_group>
    <arm_group_label>Prone position</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Intervention: Lungrecruitment in prone position. Device: Ventilator Flow-i, Peak inspiratory pressure 40 cmH2O, PEEP 20 cm H2O during 30 s.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Supine position</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Intervention: Lungrecruitment in supine position. Device: Ventilator Flow-i, Peak inspiratory pressure 40 cmH2O, PEEP 20 cm H2O during 30 s. Clinical routine.</description>
  </arm_group>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Lungrecruitment manoeuver in prone position.</intervention_name>
    <description>Postoperative lungrecruitment in prone position, pressure-controlled ventilation peak inspiratory pressure 40 cm H2O combined with PEEP 20 cm H2O during 60 seconds.</description>
    <arm_group_label>Prone position</arm_group_label>
    <other_name>&quot;Prone Lungrecruitment in ventilator&quot;</other_name>
  </intervention>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Lungrecruitment manoeuver in supine position.</intervention_name>
    <description>Postoperative lungrecruitment in supine position, pressure-controlled ventilation peak inspiratory pressure 40 cm H2O combined with PEEP 20 cm H2O during 60 seconds.</description>
    <arm_group_label>Supine position</arm_group_label>
    <other_name>&quot;Supine Lungrecruitment in ventilator&quot;</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Signed informed consent&#xD;
&#xD;
          -  Scheduled cardiac surgery (CABG or valve surgery)&#xD;
&#xD;
          -  Cardiopulmonary bypass&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Diagnose of obstructive or restrictive lung disease&#xD;
&#xD;
          -  Medical therapy with bronchodilators&#xD;
&#xD;
          -  Smoking or former smoking &gt; 5 years&#xD;
&#xD;
          -  Obesity (BMI &gt; 30)&#xD;
&#xD;
          -  Perioperative FiO2 &gt;60% or PEEP &gt;12&#xD;
&#xD;
          -  Haemodynmic instability, use of inotropes (low dose vasopressors accepted)&#xD;
&#xD;
          -  Postop clinically significant bleeding (&gt;100 ml/h, reoperation)&#xD;
&#xD;
          -  Postoperative haemothorax or large pleural effusion detected with ultrasonography&#xD;
&#xD;
          -  Postoperative clinically significant pneumothorax or large chestdrain airleak&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Sven-Erik Ricksten, Professor</last_name>
    <role>Study Chair</role>
    <affiliation>The Salgrenska Academy</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Department of cardiothoracic anaesthesia, Sahlgrenska University Hospital</name>
      <address>
        <city>Gothenburg</city>
        <zip>41345</zip>
        <country>Sweden</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Sweden</country>
  </location_countries>
  <verification_date>December 2021</verification_date>
  <study_first_submitted>December 14, 2016</study_first_submitted>
  <study_first_submitted_qc>January 3, 2017</study_first_submitted_qc>
  <study_first_posted type="Estimate">January 4, 2017</study_first_posted>
  <last_update_submitted>December 23, 2021</last_update_submitted>
  <last_update_submitted_qc>December 23, 2021</last_update_submitted_qc>
  <last_update_posted type="Actual">December 28, 2021</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Sahlgrenska University Hospital, Sweden</investigator_affiliation>
    <investigator_full_name>Andreas Martinsson</investigator_full_name>
    <investigator_title>Medical Doctor</investigator_title>
  </responsible_party>
  <keyword>Postoperative pulmonary dysfunction</keyword>
  <keyword>Postoperative pulmonary complication</keyword>
  <keyword>Recruitment manouver</keyword>
  <keyword>Prone position</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Pulmonary Atelectasis</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03009331
org study id: AMartinssonthorax
nct id: NCT03009331
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The study comprises two different objectives. Longitudinal description of postoperative
      pulmonary dysfunction in the cardiothoracic surgery patient, and the comparison of two
      different lungrecruitment strategies.
Introduction:

      Atelectasis and consolidation of lung tissue is a well recognized clinical scenario following
      anaesthesia, musclerelaxation and mechanical ventilation. In cardiac surgery during
      cardiopulmonary bypass (CPB), the lungs are collapsed to a degree depending on surgical
      opening of the pleura, time on bypass, and gasmixture on termination of ventilation.
      Recruitment of the lungs on commencement of mechanical ventilation after CPB generally must
      be repeated before extubation. There are several different approaches to Recruitment
      Manoeuvers (RM). Increasing pressures in the ventilator (peak-pressures and PEEP), increasing
      tidal volumes and inspiratory hold are facilities offered by the ventilator. Different body
      positions by interaction of the abdomen and thorax through the diaphragm, and the action of
      gravity on the lungs and adjoining organs, are other principles. The contribution of
      spontaneous ventilatory efforts also play a major roll.

      Study rationale:

      The study comprises two different objectives. Longitudinal description of postoperative
      pulmonary dysfunction in the cardiothoracic surgery patient, and the comparison of two
      different lungrecruitment strategies.

      All patients undergoing cardiothoracic surgery develops some degree of postoperative
      pulmonary dysfunction (PPD), including hypoxemia, increased work of breathing, shallow
      respiration and ineffective cough. Respiratory symptoms of larger clinical significance are
      better investigated, known as postoperative pulmonary complications (PPC), including pleural
      effusion, atelectasis, pneumonia and ARDS. Pathophysiology is complex and multifactorial, and
      there is a continuum between PPD and PPC that has not yet been well explored. A large
      proportion of patients readmitted to CICU present respiratory failure, significantly
      accounting for morbidity, mortality, and costs.

      Regarding lungrecruitment, supine position is compared to modified prone position with
      similar ventilator settings. Initial measurements preoperatively in the awake patient, then
      during sedation and ventilator treatment, followed up by measurements before discharge from
      the surgical ward on postoperative day 4-5.

      Effect of RM is evaluated from ventilator measurement of compliance (C), arterial oxygenation
      and P/F-ratio from the arterial blood gas (ABG), and electrical impedance tomography (EIT).
      EIT measures the impedance of a thoracic sagittal section by emitting and sampling electrical
      currents between 16 electrodes fixed on a submamillar belt. Radiology report from routine
      chest X-ray and ultrasonography of the lungs and pleura will be added.

      Should RM in prone position prove to be more efficient, postoperative complications in terms
      of respiratory failure and pneumonia could be reduced, facilitating postoperative recovery
      and shortening convalescens. This would justify the increased burden of care in the cardiac
      ICU.

      Study objectives:

      The study aims to compare lung recruitment in two different body positions, supine (elevated
      30 degrees) to left modified prone position (left side up, 120 degrees). Parameters
      investigated are global and regional pulmonary impedance (EIT), lungcompliance, and arterial
      oxygenation. Chest X-ray and lung ultrasound will be performed for additional analyses.

      A descriptive longitudinal study of the 20 patients lungrecruited in supine position will
      also be performed.

      Study design:

      Prospective, randomized clinical trial. Two groups with 20 cardiac surgery patients in each.

      Study procedure:

      Protocol

      Day -1:

      1 day preop. EIT measurement in supine (30 degrees elevated) and modified left prone position
      (left side up, 120 degrees). Two measurements of each 2 min duration in both positions. ABG
      is performed after breathing through a Venturi-mask delivering FiO2 0.5 for 10 minutes.
      Randomization to either of the two groups.

      Day 0:

      Day of surgery. Standard periop care in coherence with department routines. Preoxygenation
      using FiO2 1.0 during induction of anaesthesia, and before commencing cardiopulmonary bypass
      (CPB). Inhalational anaesthetics during surgical preparation, and again after weaning from
      CPB. Apnoea without PEEP or intermittent ventilation during CPB. Before weaning from CPB
      manual lung recruitment with the APL-valve set to 30 cm H2O, and visual guidance of the
      lungparenchyma or pleura. After chest closure, FiO2 is set to 0.5, volume controlled
      ventilation 4-6 ml/Kg titrated according to pCO2, and PEEP is set to 5 cm H2O. Patient
      ventilation circuit will be broken twice in conjugation with the use of a transport
      ventilator device before arrival in the CICU. Ventilator settings in the CICU is
      pressure-regulated volume-controlled ventilation (VKTS), tidal volumes of 4-6 ml/Kg titrated
      according to pCO2, respiratory frequency of 14/min, and PEEP 8 cm H2O.

      Recruitment maneuver (RM) is performed within 10 min on arrival in the CICU. Patient must be
      stabile in hemodynamic parameters, including volume status. PEEP is set to 20 cm H2O,
      pressure controlled ventilation with peak pressure 40 cm H2O for 30 s (5 inspirations),
      thereafter PEEP-trial starting from 15 cm H2O for optimal PEEP using the "Open Lung Tool"
      (Maquet Flow-i software). During the PEEP-trial, VKTS for tidal volumes of 6 ml/Kg is used.

      Supine position group: RM in supine position. EIT, ABG and lung compliance measurements in
      supine position before RM (30 degrees elevation), then immediately and 30 min after RM, and
      again 30 minutes after extubation. FiO2 0.5 at all ABG measuring points.

      Modified prone position group: RM in modified prone position (120 degrees, left side up).
      EIT, ABG and lung compliance measurements in supine position before RM (30 degrees
      elevation), and then immediately after RM when turned back to supine position (30 degrees
      elevation), and 30 minutes after RM. Finally, measurements 30 minutes after extubation. FiO2
      0.5 at all ABG measuring points.

      Day 4-5:

      Supine and prone position groups: EIT in supine position (30 degrees elevation) and ABG
      repeated at day 4-5 postop. ABG is performed after breathing through a Venturi-mask
      delivering FiO2 0.5 for 10 minutes. Ultrasonography of the pleurae. Chest-X-ray performed
      routinely on the day after chest-drain removal.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Supportive Care
masking: None (Open Label)
measure: Electrical impedance
time frame: 5 days
description: Electrical impedance tomography, thoracical transverse plane measurment. Dräger Pulmovista device is used for collecting the data. Data will be transferred to a personal computer, and processed in Excel.
measure: Lungcompliance (ml/cm H2O)
time frame: 2 hours
description: Pulmonary dynamic compliance, ventilator measurment.
measure: P/F ratio
time frame: 5 days
description: Oxygenation ratio, pO2 divided by FiO2, indication of pulmonary shunt
measure: Ultrasonography
time frame: 5 days
description: Lungultrasound to exclude pleural effusion.
measure: Chest X-ray
time frame: 5 days
description: Chest X-ray to exclude pneumothorax
measure: Safety and Tolerability of prone position (turned 180 dgrees from supine position, Intensive Care Unit Bed), number of adverse events observed by the primary investigator.
time frame: 2 hours
description: Placing a patient in prone position in the immediate postoperative and sedated setting in the Cardiac Intensive Care Unit. Adverse events will be observed and noted by the primary investigator. Adverse events will be divided in less severe (e.g disruption of monitoring, uncoupling of breathing curcuit) and severe (e.g accidental extubation, decubitus ulcers, emergency return to supine position).
arm group label: Prone position
arm group type: Experimental
description: Intervention: Lungrecruitment in prone position. Device: Ventilator Flow-i, Peak inspiratory pressure 40 cmH2O, PEEP 20 cm H2O during 30 s.
arm group label: Supine position
arm group type: Active Comparator
description: Intervention: Lungrecruitment in supine position. Device: Ventilator Flow-i, Peak inspiratory pressure 40 cmH2O, PEEP 20 cm H2O during 30 s. Clinical routine.
intervention type: Procedure
intervention name: Lungrecruitment manoeuver in prone position.
description: Postoperative lungrecruitment in prone position, pressure-controlled ventilation peak inspiratory pressure 40 cm H2O combined with PEEP 20 cm H2O during 60 seconds.
arm group label: Prone position
other name: "Prone Lungrecruitment in ventilator"
intervention type: Procedure
intervention name: Lungrecruitment manoeuver in supine position.
description: Postoperative lungrecruitment in supine position, pressure-controlled ventilation peak inspiratory pressure 40 cm H2O combined with PEEP 20 cm H2O during 60 seconds.
arm group label: Supine position
other name: "Supine Lungrecruitment in ventilator"
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Sven-Erik Ricksten, Professor
role: Study Chair
affiliation: The Salgrenska Academy
facility: 
country: Sweden
responsible party type: Principal Investigator
investigator affiliation: Sahlgrenska University Hospital, Sweden
investigator full name: Andreas Martinsson
investigator title: Medical Doctor
mesh term: Pulmonary Atelectasis
sharing ipd: No