postoperative pulmonary complications
Conditions
Interventions
Study Group:Right after the position of the double lumen tube is comfirmed in lateral decubitus position,one lung ventilation is initiated followed by decremental PEEP titration
Control Group:Right after pleura opening, one lung ventilation is initiated, followed by a recruitment maneuver and aubsequent individualized PEEP titration
Sponsors
Peking University Third Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: Patients scheduled for elective video-assisted pulmonary lobe or segment resection under general anesthesia,age between 18 and 75 years old; ASA status of III or lower; double lumen tube will be used for lung isolation; length of one lung ventilation exceeds that of two lung ventilation; anticipated to undergo one lung ventilation for over an hour.BMI<30
Exclusion criteria
Exclusion criteria: Parous; history of COPD ( defined as GOLD classification III to IV); with pulmonary fibrosis; requiring devices other than double lumen tube for lung isolation; bulla on the dependent lung; with severe pneumothorax or emphysema; with congestive heart failure (defined as NYHA classification III to IV); history of pulmonary surgery; dependent on renal replacement therapy; history of acute respiratory infection (within one month prior to surgery); pulmonary arterial hypertension (defined as mean pulmonary arterial pressure exceeding 25mmHg during rest or systolic pulmonary arterial pressure over 40mmHg); known or suspected neuromuscular illnesses (thymoma, myasthenia gravis, myopathy, myodystrophy); planned for postoperative mechanical ventilation; scheduled for bilateral surgery; scheduled for surgery in prone position; sustained hemodynamic instability or refractory shock (according to the judgement by the anesthesiologist in charge); known significant lung injury(PaCO2>50mmHgPaO2<50mmHg); taking ACEI or ARB to treat hypertension. Dropout criteria: unplanned thoracotomy conversion, intraoperative blood loss surpassing 500ml.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| oxygenation index; | — |
Secondary
| Measure | Time frame |
|---|---|
| results of blood gas analysis;Qs/Qt;respirtory parameters;anesthesia associated parameters; | — |
Countries
China
Contacts
Public ContactQingyuan Wang
Peking University Third Hospital
Outcome results
None listed