Determination of Optimal Positive End-expiratory Pressure Using Electrical Impedance Tomography in Children Under General Anesthesia: Comparison Between Supine and Prone Positions

NCT05275309 — Not applicable, Completed, 33 participants, Seoul National University Hospital

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Registry	NCT05275309
Status	Completed
Phase	Not applicable
Study type	Interventional; na, single group, masking: none, diagnostic
Enrollment	33 (Actual)
Sponsor	Seoul National University Hospital (Other)
Conditions	General Anesthesia
Interventions	Exploration of optimal PEEP in supine and prone position (Other)
Dates	start 2022-03-14, primary completion 2022-12-30, completion 2022-12-30, first posted 2022-03-11, last updated 2023-01-20
Locations	1 site in South Korea

-Summary

The purpose of this study was to determine the appropriate positive end-expiratory pressure (PEEP) using electrical impedance tomography (EIT) in children under general anesthesia and to investigate whether there is a difference between the supine and prone positions.

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+Arms and interventions

Arm	Type	Interventions	Description
Children <= 1 years old	Experimental	Other: Exploration of optimal PEEP in supine and prone position	Pediatric patients <= 1 years old of age scheduled for surgery in the prone position

Exploration of optimal PEEP in supine and prone position (Other): 1. General anesthesia is done in routine manner 2. A sensor for electrical impedance tomography (EIT) is applied around the patient's chest. 3. In supine position, lung recruitment maneuver is done, followed by decremental PEEP trial. Based on EIT parameter, optimal PEEP which induces minimal overdistension and collapse of lungs is determined. 4. One hour after prone position, optimal PEEP is determined again.

+Outcome measures

Primary outcomes

Optimal PEEP level at spine position [10 minutes after intubation (supine)]: Optimal PEEP level (cmH2O) determination using electrical impedance tomography at supine position
Optimal PEEP level at prone position [1 hour after prone positioning (prone)]: Optimal PEEP level (cmH2O) determination using electrical impedance tomography at prone position

Secondary outcomes

Dynamic compliance measured using Electrical impedance tomography [until 1 hour after prone positioning]: ventilation/pressure (ml/cmH2O)
regional ventilation delay measured using Electrical impedance tomography [until 1 hour after prone positioning]: ventilation time delay during one breath (no unit)
pulmonary opening pressure measured using Electrical impedance tomography [until 1 hour after prone positioning]: alveoli opening pressure (cmH2O)
atelectasis/overdistension ratio measured using Electrical impedance tomography [until 1 hour after prone positioning]: The degree comparing atelectasis and overdistension (no unit)

+Eligibility

Sex: All, ages: any to 1 Year

Inclusion Criteria:

* Children <= years of age who are scheduled for surgery in the prone position under general anesthesia

Exclusion Criteria:

* Respiratory distress, bronchopulmonary dysplasia
* Pneumothorax
* Increased intracranial pressure
* History of airway surgery
* Cervical or thoracic surgery
* Pulmonary hypertension

+Locations (1)

Facility	City	Country	Status
Hee-Soo Kim	Seoul	South Korea

+Investigators

Hee-Soo Kim, MD, PhD, Principal investigator, Seoul National University Hospital