Effect of Electrical Impedance Tomography-Guided Early Mobilization in Patients After Major Upper Abdominal Surgery: Protocol for a Prospective Cohort Study

Xuan Song; Daqiang Yang; Maopeng Yang; Yahu Bai; Bingxin Qin; Shoucheng Tian; Gangbing Song; Xiuyan Guo; Ranran Dong; Yuanyuan Men; Ziwei Liu; Xinyan Liu; Chunting Wang

doi:10.3389/fmed.2021.710463

Effect of Electrical Impedance Tomography-Guided Early Mobilization in Patients After Major Upper Abdominal Surgery: Protocol for a Prospective Cohort Study

Front Med (Lausanne). 2021 Dec 9:8:710463. doi: 10.3389/fmed.2021.710463. eCollection 2021.

Authors

Xuan Song^{1

2}, Daqiang Yang^{1

2}, Maopeng Yang^{1

2}, Yahu Bai^{1

2}, Bingxin Qin^{1

2}, Shoucheng Tian^{1

2}, Gangbing Song^{1

2}, Xiuyan Guo³, Ranran Dong^{1

2}, Yuanyuan Men^{1

2}, Ziwei Liu⁴, Xinyan Liu^{1

2}, Chunting Wang⁵

Affiliations

¹ Intensive Care Unit (ICU), Liaocheng Cardiac Hospital, Liaocheng, China.
² Intensive Care Unit (ICU), Dong E Hospital Affiliated to Shandong First Medical University, Liaocheng, China.
³ Education Department, Dong E Hospital Affiliated to Shandong First Medical University, Liaocheng, China.
⁴ Internal Medicine, Qingdao University, Qingdao, China.
⁵ Intensive Care Unit (ICU), Shandong Provincial Hospital Affiliated to Shandong First Medical University, Liaocheng, China.

Abstract

Background: Pulmonary complications are common in patients after upper abdominal surgery, resulting in poor clinical outcomes and increased costs of hospitalization. Enhanced Recovery After Surgery Guidelines strongly recommend early mobilization post-operatively; however, the quality of the evidence is poor, and indicators for quantifying the effectiveness of early mobilization are lacking. This study will evaluate the effectiveness of early mobilization in patients undergoing an upper abdominal surgery using electrical impedance tomography (EIT). Specifically, we will use EIT to assess and compare the lung ventilation distribution among various regions of interest (ROI) before and after mobilization in this patient population. Additionally, we will assess the temporal differences in the distribution of ventilation in various ROI during mobilization in an effort to develop personalized activity programs for this patient population. Methods: In this prospective, single-center cohort study, we aim to recruit 50 patients after upper abdominal surgery between July 1, 2021 and June 30, 2022. This study will use EIT to quantify the ventilation distribution among different ROI. On post-operative day 1, the nurses will assist the patient to sit on the chair beside the bed. Patient's heart rate, blood pressure, oxygen saturation, respiratory rate, and ROI 1-4 will be recorded before the mobilization as baseline. These data will be recorded again at 15, 30, 60, 90, and 120 min after mobilization, and the changes in vital signs and ROI 1-4 values at each time point before and after mobilization will be compared. Ethics and Dissemination: The study protocol has been approved by the Institutional Review Board of Liaocheng Cardiac Hospital (2020036). The trial is registered at chictr.org.cn with identifier ChiCTR2100042877, registered on January 31, 2021. The results of the study will be presented at relevant national and international conferences and submitted to international peer-reviewed journals. There are no plans to communicate results specifically to participants. Important protocol modifications, such as changes to eligibility criteria, outcomes, or analyses, will be communicated to all relevant parties (including investigators, Institutional Review Board, trial participants, trial registries, journals, and regulators) as needed via email or in-person communication.

Keywords: early mobilization; electrical impedance tomography (EIT); post-operative pulmonary complications; region of interest; upper abdominal surgery.