Effects of Periodic Recruitment Maneuvers on Atelectasis and Respiratory Mechanics During Elective Spine Surgery Assessed by Lung Ultrasonography
Recruiting now · Not applicable
Conditions studied: Atelectasis, Mechanical Ventilation, General Anesthesia, Prone Position
In brief
During general anesthesia, particularly in patients undergoing spine surgery in the prone (face-down) position, increased intrathoracic and abdominal pressure may reduce lung compliance and promote the development of atelectasis (partial lung collapse). Atelectasis can impair intraoperative oxygenation and may increase the risk of postoperative pulmonary complications. Alveolar recruitment maneuvers (ARM) are routinely used in anesthesia practice to reopen collapsed lung regions; however, it remains unclear whether periodic application of ARM throughout surgery provides additional benefit compared with standard single-time application. This prospective, randomized controlled clinical study aims to evaluate whether periodic alveolar recruitment maneuvers applied during elective spine surgery in the prone position reduce intraoperative atelectasis and improve respiratory mechanics compared with the standard approach of performing ARM only after positioning and before extubation. Adult patients undergoing elective spine surgery under general anesthesia will be randomly assigned to either a periodic ARM group or a standard ARM group. Lung aeration will be assessed using lung ultrasound, a non-invasive and radiation-free bedside imaging method. The primary outcome is the incidence of intraoperative atelectasis assessed before extubation. Secondary outcomes include lung ultrasound aeration scores, respiratory mechanics parameters (such as airway pressures and compliance), oxygenation indices, and the occurrence of transient intraoperative respiratory or hemodynamic events. The findings of this study may help optimize intraoperative ventilation strategies in prone spine surgery and contribute to improved perioperative respiratory safety.
Key facts
- Study ID
- NCT07325812
- Run by
- Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization
- People needed
- 60
- Starts
- 2026-04-01
- Expected to finish
- 2026-07-01
- Last updated by the study team
- 2026-04-08
Who can join
Age: 18 and older, up to 65. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Adults aged 18 to 65 years
- Scheduled for elective lumbar spine surgery under general anesthesia
- Surgery planned to be performed in the prone position
- Expected surgical duration of at least 2 hours
- American Society of Anesthesiologists (ASA) physical status I-II
- Ability to provide written informed consent
You may not qualify if…
- Body mass index (BMI) greater than 30 kg/m²
- History of thoracic surgery
- Known or suspected chronic pulmonary disease (e.g., chronic obstructive pulmonary disease, restrictive lung disease)
- Clinically significant cardiac disease
- Pregnancy or breastfeeding
- Known airway anomalies
- Intraoperative surgical duration shorter than 2 hours
- Refusal or inability to provide informed consent
Where it is running
- Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization — Istanbul, Turkey (Türkiye) (enrolling)
Full record on ClinicalTrials.gov
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