Individualized open lung perioperative ventilatory approach in laparoscopy emergency abdominal

A multicenter prospective randomized controlled trial.

iPROVE-EAL + PEAL is an international project, in which centers of different countries of the world. It consists of two phases: a first observational phase (PEAL) and a second phase of clinical trial (iPROVE-EAL). This means that in the first phase of the study will not change the usual clinical practice, nor will any treatment be carried out additional or alternative, but the data of what is done in a way that is going to be collected usual (more detailed in the study protocol).

Postoperative pulmonary complications (PPCs) are postoperative complications more frequent, with a significant impact on morbidity, mortality and consumption of resources of the health system. It has been observed that the incidence of CPP in this population ranges from 20% described in observational cohort studies to 40% in trials
randomized clinics. However, the incidence of CPP in patients undergoing surgery. Urgent abdominal pain is not well defined. The Lung Protective Ventilation Strategy aims to minimize the lung injury favored by mechanical ventilation and, therefore, reduce CPPs. The open lung strategy (OLA), which until now has been defined as a strategy that combines recruitment maneuvers to open alveolar collapse followed by a positive end-tidal pressure level to prevent recollapse, aims to homogenize the lung, reducing the risk of lung injury and therefore the appearance of CPP. However, the literature is not conclusive on the benefits that this strategy has on CPPs.

We intend to carry out a prospective study that analyzes the incidence of complications. Postoperative pulmonary disorders in patients undergoing urgent abdominal surgery, describing the usual ventilatory management and the perioperative factors associated with its appearance. Different studies show a direct relationship between complications lung disease and a slowing of the patient’s recovery, the non-recovery of the baseline preoperative status and even higher risk of mortality compared with patients They do not suffer postoperative complications.