Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol for a randomized controlled trial

Background: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multicenter, two-arm, international randomized controlled trial. In total, 2013 obese patients with body mass index ≥35 kg/m2 scheduled for at least 2 h of surgery under general anesthesia and at intermediate to high risk for PPCs will be included. Patients are ventilated intraoperatively with a low tidal volume of 7 ml/kg (predicted body weight) and randomly assigned to PEEP of 12 cmH2O with lung recruitment maneuvers (high PEEP) or PEEP of 4 cmH2O without recruitment maneuvers (low PEEP). The occurrence of PPCs will be recorded as collapsed composite of single adverse pulmonary events and represents the primary endpoint. Discussion To our knowledge, the PROBESE trial is the first multicenter, international randomized controlled trial to compare the effects of two different levels of intraoperative PEEP during protective low tidal volume ventilation on PPCs in obese patients. The results of the PROBESE trial will support anesthesiologists in their decision to choose a certain PEEP level during general anesthesia for surgery in obese patients in an attempt to prevent PPCs. Trial registration ClinicalTrials.gov identifier: NCT02148692. Registered on 23 May 2014; last updated 7 June 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1929-0) contains supplementary material, which is available to authorized users

Preparation, Characterization and Catalytic Properties of SBA-15-SO₃H Supported Tungstophosphoric Acid for Esterification Reaction

SBA-15-SO₃H supported tungstophosphoric acid (TPA, H₃PW₁₂O₄₀) mesoporous materials were synthesized by impregnation of TPA into the hydrothermally synthesized SBA-15-SO₃H and the catalytic performances were compared for the esterification reaction. The physical and chemical properties of the catalysts were characterized by XRD, SEM/EDX, FT-IR and N₂ adsorption/desorption techniques. The characterization results show that TPA/SBA-15-SO₃H retained the typical mesoporous structure of SBA-15-SO₃H. The experimental results indicated that TPA/SBA-15-SO₃H is a more efficient catalyst than SBA-15-SO₃H for the esterification reaction. The higher activity of TPA/SBA-15-SO₃H compared with that of SBA-15-SO₃H was consistent with the material having the low pKa value, confirming that the esterification rate was mostly dependent on the acid strength of the additional functional groups of solid acid catalyst. Accordingly, the reason for the catalytic activity difference was simply explicated by the effect of TPA, having low pKa value, affecting the pore structure and the total acidity

An investigation of equine infectious anaemia infection in the Central Anatolia region of Turkey

In this study, 162 horses, 80 donkeys and 51 mule serum samples were collected in Konya city. Additionally, 64 horse serum samples from Ankara and 49 samples from Kayseri city were included in the study. A total of 406 serum samples were examined by agar gel immunodiffusion (AGID) and enzyme-linked immunosorbent assay (ELISA) for antibody to equine infectious anaemia virus (EIAV) and no positive result was detected

Spinal cord tissue detection on the joints of beef carcass in a private abattoir in Southern Turkey

In this study, the distribution of Central Nervous System (CNS) tissue contamination on the joints of beef during cutting of 88 carcass halves in a private slaughterhouse was investigated. In conclusion, the first time in Turkey, the level of contamination of spinal cord tissue as CNS tissue on the joints of beef during cutting the carcasses into the parts was shown. Additionally, high level of contamination risk via the knives used for cutting carcasses, the cutting tables, the moving cutting tables and the aprons was detected

Comparison of equipotent doses of ropivacaine-fentanyl and bupivacaine-fentanyl in spinal anaesthesia for lower abdominal surgery

The aim of this randomised, double-blind study was to compare equipotent doses of plain ropivacaine and bupivacaine (19.5 mg and 73 mg respectively), both with fentanyl 20 mu g, for spinal anaesthesia in lower abdominal surger

Reducing tidal volume does not affect oxygenation in ASA I-II patients during anesthesia

The aim of this study was to evaluate the need of high tidal volumes for mechanical ventilation during general anesthesia

Predictive Factors Involved in Development of Postoperative Pulmonary Complications

Objective: In the present study, we applied the method of the multi-center Prospective Evaluation of a Risk Score for postoperative pulmonary Complications in Europe (PERISCOPE) study, which was designed to predict postoperative complications and funded by the European Society of Anaesthesiology, to patients in our institution with the aim of prospectively analyzing the postoperative risk factors of pulmonary complications