Grant: Project Grant

Respiratory complications (e.g., pneumonia, lung collapse) after general anesthesia are frequent (10-40%). While many of them will have little or no impact on patients, others can lead to a prolonged hospitalisation, an unplanned need for treatment in an intensive care unit, or death. A number of studies have investigated whether delivering oxygen to patients using different mechanical ventilator settings may decrease the number of respiratory complications. These studies report variable and contradictory effects. Most surgeries are performed under general anesthesia during which a breathing tube is placed in patients' lungs by their anesthesiologist. Removing that tube (extubation) is a very common procedure for anesthesiologists in their daily clinical practice. Research suggests that a properly performed extubation may be an important step to decrease respiratory complications after general anesthesia. Surprisingly, very little research is available to help anesthesiologists decide how best to perform extubation. This trial will test a simple strategy of keeping the lungs fully opened during extubation instead of letting them partially collapse. This trial will be conducted in four different Canadian hospitals. Patients undergoing surgery inside their abdomen will be randomly assigned to the usual conventional approach to safe extubation (partial lung collapse) or to receive a new approach to safe extubation (keeping lungs fully opened). This small pilot trial will test whether it is feasible to organise a bigger trial evaluating whether a strategy to keep the lungs fully open is superior to a strategy of letting the lungs partially collapse to reduce respiratory complications after general anesthesia.