Postoperative AtelectasisNCT07676760
HFNC for Postoperative Atelectasis After Laparoscopic Surgery
An observational study of Postoperative Atelectasis and Postoperative Pulmonary Complications, run by Bursa Yuksek Ihtisas Training and Research Hospital.
Trial summary
Pneumoperitoneum and Trendelenburg positioning during laparoscopic surgery promote atelectasis development, which has been reported in up to 90% of patients under general anesthesia and increases the risk of postoperative pulmonary complications. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Postoperative Atelectasis, Postoperative Pulmonary Complications
- What is being tested?
- High-Flow Nasal Cannula (HFNC) and Conventional Oxygen Therapy
- How many people
- 90 participants
- Where
- No sites listed yet
- Study dates
- Jul 2026to Jul 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Adult patients aged 18-75 years scheduled for elective laparoscopic surgery (general surgery, urology, and gynecology) under general anesthesia.
Who may be able to join
- Adult patients aged 18 years and older
- Patients scheduled for elective laparoscopic surgery (general surgery, urology, gynecology)
- Patients undergoing mechanical ventilation under general anesthesia
- ASA physical status I-III
- Patients providing written informed consent
Who cannot join
- Severe or uncontrolled chronic obstructive pulmonary disease, asthma, or other chronic pulmonary diseases
- Patients with atelectasis or pleural effusion detected on preoperative lung ultrasonography
- Patients requiring intraoperative recruitment maneuver
- ASA physical status IV or above
- Patients receiving spinal or epidural anesthesia
- Cases requiring conversion to laparoscopy or laparotomy
- Patients refusing to participate
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: The Role of High-Flow Nasal Cannula in Monitoring Postoperative Atelectasis With Lung Ultrasonography After Laparoscopic Surgery: A Prospective Observational Study
Pneumoperitoneum and Trendelenburg positioning during laparoscopic surgery promote atelectasis development, which has been reported in up to 90% of patients under general anesthesia and increases the risk of postoperative pulmonary complications. High-flow nasal cannula (HFNC) oxygen therapy may reduce post-extubation atelectasis through alveolar recruitment. This prospective observational cohort study aims to evaluate the role of HFNC in postoperative atelectasis monitored by lung ultrasonography (LUS) in patients undergoing elective laparoscopic surgery.
Read the detailed description
General anesthesia with laparoscopic surgery causes cephalad diaphragm displacement and reduction in functional residual capacity due to pneumoperitoneum and Trendelenburg positioning, predisposing patients to atelectasis development. Perioperative atelectasis has been reported in up to 90% of patients under general anesthesia, increasing the risk of hypoxemia, prolonged oxygen therapy, and postoperative pulmonary complications (PPCs).
High-flow nasal cannula (HFNC) oxygen therapy supports alveolar recruitment, enhances mucociliary clearance, and may reduce post-extubation atelectasis through heated and humidified gas delivery and generation of low-level positive end-expiratory pressure (PEEP). Randomized controlled trials have demonstrated that HFNC significantly reduces the incidence and severity of atelectasis assessed by LUS in robot-assisted laparoscopic rectal cancer surgery. Lung ultrasonography (LUS) has emerged as a reliable, rapid, and radiation-free method for diagnosis and monitoring of perioperative atelectasis with 87.7% sensitivity and 92.1% specificity.
This study is designed as a prospective, observational, single-center, parallel-group cohort study. No intervention or randomization will be performed. HFNC application will be left entirely to the clinician's discretion; the investigator will not be involved in the treatment process.
Patients in whom HFNC is initiated by the clinician in the post-extubation period will be defined as Group 1 (HFNC group), and patients receiving conventional oxygen therapy will be defined as Group 2 (Control group). HFNC application will be considered valid if initiated within 30 minutes of extubation.
LUS assessments will be performed by an independent investigator blinded to group assignment at four time points: T0 (preoperative), T1 (post-extubation), T2 (30th minute in the recovery unit), and T3 (discharge from the recovery unit). An additional LUS assessment is planned at postoperative 24 hours (T4). The Monastesse modified LUS score will be used at each assessment, evaluating 12 thoracic regions (6 segments per hemithorax along parasternal, anterior axillary, and posterior axillary lines), with a total LUS score ranging from 0 to 36 points.
HFNC parameters (flow rate, FiO₂, duration) and intraoperative variables (type and duration of surgery, anesthesia duration, insufflation duration, pneumoperitoneum pressure, Trendelenburg angle, total fluid intake, urine output) as well as postoperative variables (minimum SpO₂ in the recovery unit, length of hospital stay) will be considered as potential confounding factors in the statistical analysis.
- Being tested
- High-Flow Nasal Cannula (HFNC), Conventional Oxygen Therapy
- Keywords
- High-Flow Nasal Cannula, Lung Ultrasonography, Postoperative Atelectasis, Laparoscopic Surgery, Pneumoperitoneum
- Medical subject headings
- Pneumoperitoneum
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
High-Flow Nasal Cannula (HFNC)Other
HFNC Group
Conventional Oxygen TherapyOther
Standard oxygen therapy administered via face mask or nasal cannula after extubation following elective laparoscopic surgery.
| Study group | Role | What they receive |
|---|---|---|
| HFNC Group | Patients in whom high-flow nasal cannula (HFNC) oxygen therapy is initiated by the clinician within 30 minutes of extubation after elective laparoscopic surgery. Receives: Other: High-Flow Nasal Cannula (HFNC) | |
| Control Group | Patients receiving conventional oxygen therapy after extubation following elective laparoscopic surgery. Receives: Other: Conventional Oxygen Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Total Lung Ultrasonography Score (LUS Score)
Total lung ultrasonography score assessed using the Monastesse modified LUS scoring system. Each hemithorax is divided into 6 segments along parasternal, anterior axillary, and posterior axillary lines, evaluating a total of 12 thoracic regions with a total score ranging from 0 to 36 points. Scores are compared between HFNC and conventional oxygen therapy groups.
Measured: T0: preoperative; T1: 5th minute after extubation; T2: 30th minute in the recovery unit; T3: discharge from the recovery unit
Secondary outcomes (5)
Incidence of Significant Atelectasis
Proportion of patients with at least one lung region scoring ≥2 on the LUS scoring system (coalescing B-lines/irregular pleura or consolidation >1×2cm) at each time point.
Measured: T0: preoperative; T1: 5th minute after extubation; T2: 30th minute in the recovery unit; T3: discharge from the recovery unit
Minimum SpO₂ in the Post-Anesthesia Care Unit (PACU)
Minimum oxygen saturation recorded during the entire post-anesthesia care unit stay.
Measured: From extubation to PACU discharge, up to 2 hours
Incidence of Hypoxemia
Proportion of patients with SpO₂ below 95% during the post-anesthesia care unit stay.
Measured: From extubation to PACU discharge, up to 2 hours
Incidence of Severe Hypoxemia
Proportion of patients with SpO₂ below 90% during the post-anesthesia care unit stay.
Measured: From extubation to PACU discharge, up to 2 hours
Postoperative Complications
Incidence and type of postoperative complications recorded during hospital stay.
Measured: From surgery to hospital discharge, up to 7 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Jun 2026
- Study startJul 2026 (estimated)
- Primary completionJul 2027 (estimated)
- Study completionJul 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Postoperative AtelectasisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 90 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Bursa Yuksek Ihtisas Training and Research Hospital
- Sponsor type
- Other government
- Responsible party
- Principal investigator, Selvinaz Yüksel Tanrıverdi, Bursa Yuksek Ihtisas Training and Research Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07676760
- Sponsor's protocol ID
- BursaYIERHTanriverdi-002
- Status last verified
- Jun 2026
- First submitted
- 23 Jun 2026
- Last updated
- 30 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Han L, Ren D, Zhu M, Pan L, Zhu Y. High-flow nasal cannula oxygen therapy in post-anesthesia care unit (PACU) reduces postextubation atelectasis in patients undergoing esophageal cancer surgery: A randomized controlled trial. PLoS One. 2026 May 5;21(5):e0348511. doi: 10.1371/journal.pone.0348511. eCollection 2026.
PubMed 42085443Sun L, Wang J, Wei P, Ruan WQ, Guo J, Yin ZY, Li X, Song JG. Randomized Controlled Trial Investigating the Impact of High-Flow Nasal Cannula Oxygen Therapy on Patients Undergoing Robotic-Assisted Laparoscopic Rectal Cancer Surgery, with a Post-Extubation Atelectasis as a Complication. J Multidiscip Healthc. 2024 Jan 26;17:379-389. doi: 10.2147/JMDH.S449839. eCollection 2024.
PubMed 38292922
Study at a glance
From the registry record, last updated by the sponsor on 30 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Role of High-Flow Nasal Cannula in Monitoring Postoperative Atelectasis With Lung Ultrasonography After Laparoscopic Surgery: A Prospective Observational Study
- ClinicalTrials.gov ID
- NCT07676760
- Acronym / sponsor ID
- BursaYIERHTanriverdi-002
- Keywords
- High-Flow Nasal Cannula, Lung Ultrasonography, Postoperative Atelectasis, Laparoscopic Surgery, Pneumoperitoneum
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 90 participants (estimated)
- Lead sponsor
- Bursa Yuksek Ihtisas Training and Research HospitalOther government
- Study start
- Jul 2026 (estimated)
- Primary completion
- Jul 2027 (estimated)
- Study completion
- Jul 2027 (estimated)
- First posted
- 30 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Pneumoperitoneum and Trendelenburg positioning during laparoscopic surgery promote atelectasis development, which has been reported in up to 90% of patients under general anesthesia and increases the risk of postoperative pulmonary complications. High-flow nasal cannula (HFNC) oxygen therapy may reduce post-extubation atelectasis through alveolar recruitment. This prospective observational cohort study aims to evaluate the role of HFNC in postoperative atelectasis monitored by lung ultrasonography (LUS) in patients undergoing elective laparoscopic surgery.
Detailed description
General anesthesia with laparoscopic surgery causes cephalad diaphragm displacement and reduction in functional residual capacity due to pneumoperitoneum and Trendelenburg positioning, predisposing patients to atelectasis development. Perioperative atelectasis has been reported in up to 90% of patients under general anesthesia, increasing the risk of hypoxemia, prolonged oxygen therapy, and postoperative pulmonary complications (PPCs).
High-flow nasal cannula (HFNC) oxygen therapy supports alveolar recruitment, enhances mucociliary clearance, and may reduce post-extubation atelectasis through heated and humidified gas delivery and generation of low-level positive end-expiratory pressure (PEEP). Randomized controlled trials have demonstrated that HFNC significantly reduces the incidence and severity of atelectasis assessed by LUS in robot-assisted laparoscopic rectal cancer surgery. Lung ultrasonography (LUS) has emerged as a reliable, rapid, and radiation-free method for diagnosis and monitoring of perioperative atelectasis with 87.7% sensitivity and 92.1% specificity.
This study is designed as a prospective, observational, single-center, parallel-group cohort study. No intervention or randomization will be performed. HFNC application will be left entirely to the clinician's discretion; the investigator will not be involved in the treatment process.
Patients in whom HFNC is initiated by the clinician in the post-extubation period will be defined as Group 1 (HFNC group), and patients receiving conventional oxygen therapy will be defined as Group 2 (Control group). HFNC application will be considered valid if initiated within 30 minutes of extubation.
LUS assessments will be performed by an independent investigator blinded to group assignment at four time points: T0 (preoperative), T1 (post-extubation), T2 (30th minute in the recovery unit), and T3 (discharge from the recovery unit). An additional LUS assessment is planned at postoperative 24 hours (T4). The Monastesse modified LUS score will be used at each assessment, evaluating 12 thoracic regions (6 segments per hemithorax along parasternal, anterior axillary, and posterior axillary lines), with a total LUS score ranging from 0 to 36 points.
HFNC parameters (flow rate, FiO₂, duration) and intraoperative variables (type and duration of surgery, anesthesia duration, insufflation duration, pneumoperitoneum pressure, Trendelenburg angle, total fluid intake, urine output) as well as postoperative variables (minimum SpO₂ in the recovery unit, length of hospital stay) will be considered as potential confounding factors in the statistical analysis.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| HFNC Group | – | Other: High-Flow Nasal Cannula (HFNC)Patients in whom high-flow nasal cannula (HFNC) oxygen therapy is initiated by the clinician within 30 minutes of extubation after elective laparoscopic surgery. |
| Control Group | – | Other: Conventional Oxygen TherapyPatients receiving conventional oxygen therapy after extubation following elective laparoscopic surgery. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Adult patients aged 18-75 years scheduled for elective laparoscopic surgery (general surgery, urology, and gynecology) under general anesthesia.
Key inclusion criteria (5 listed)
- Adult patients aged 18 years and older
- Patients scheduled for elective laparoscopic surgery (general surgery, urology, gynecology)
- Patients undergoing mechanical ventilation under general anesthesia
- ASA physical status I-III
- Patients providing written informed consent
Key exclusion criteria (7 listed)
- Severe or uncontrolled chronic obstructive pulmonary disease, asthma, or other chronic pulmonary diseases
- Patients with atelectasis or pleural effusion detected on preoperative lung ultrasonography
- Patients requiring intraoperative recruitment maneuver
- ASA physical status IV or above
- Patients receiving spinal or epidural anesthesia
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| High-Flow Nasal Cannula (HFNC)HFNC Group | Other | HFNC Group |
| Conventional Oxygen TherapyStandard oxygen therapy administered via face mask or nasal cannula after extubation following elective laparoscopic surgery. | Other | Control Group |
Primary outcome
Total Lung Ultrasonography Score (LUS Score)
Time frame: T0: preoperative; T1: 5th minute after extubation; T2: 30th minute in the recovery unit; T3: discharge from the recovery unit
Total lung ultrasonography score assessed using the Monastesse modified LUS scoring system. Each hemithorax is divided into 6 segments along parasternal, anterior axillary, and posterior axillary lines, evaluating a total of 12 thoracic regions with a total score ranging from 0 to 36 points. Scores are compared between HFNC and conventional oxygen therapy groups.
5 secondary outcomes
Incidence of Significant Atelectasis
Time frame: T0: preoperative; T1: 5th minute after extubation; T2: 30th minute in the recovery unit; T3: discharge from the recovery unit
Minimum SpO₂ in the Post-Anesthesia Care Unit (PACU)
Time frame: From extubation to PACU discharge, up to 2 hours
Incidence of Hypoxemia
Time frame: From extubation to PACU discharge, up to 2 hours
Incidence of Severe Hypoxemia
Time frame: From extubation to PACU discharge, up to 2 hours
Postoperative Complications
Time frame: From surgery to hospital discharge, up to 7 days
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Jun 2026.
- Results publication: PubMed 42085443Han L, Ren D, Zhu M, Pan L, Zhu Y. High-flow nasal cannula oxygen therapy in post-anesthesia care unit (PACU) reduces postextubation atelectasis in patients undergoing esophageal cancer surgery: A randomized controlled trial. PLoS One. 2026 May 5;21(5):e0348511. doi: 10.1371/journal.pone.0348511. eCollection 2026.
- Results publication: PubMed 38292922Sun L, Wang J, Wei P, Ruan WQ, Guo J, Yin ZY, Li X, Song JG. Randomized Controlled Trial Investigating the Impact of High-Flow Nasal Cannula Oxygen Therapy on Patients Undergoing Robotic-Assisted Laparoscopic Rectal Cancer Surgery, with a Post-Extubation Atelectasis as a Complication. J Multidiscip Healthc. 2024 Jan 26;17:379-389. doi: 10.2147/JMDH.S449839. eCollection 2024.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
An observational study of Postoperative Atelectasis and Postoperative Pulmonary Complications, run by Bursa Yuksek Ihtisas Training and Research Hospital.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 30 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Selvinaz Yüksel Tanrıverdi, MD (+0902242955000, yukselselvinaz@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Total Lung Ultrasonography Score (LUS Score) (time frame: T0: preoperative; T1: 5th minute after extubation; T2: 30th minute in the recovery unit; T3: discharge from the recovery unit). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07676760, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jun 2026; AzTrials last refreshed its copy on 27 Oct 2026.