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The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing One-lung Ventilation for Lung Surgery

The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing One-lung Ventilation for Lung Surgery

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01540201
Enrollment
110
Registered
2012-02-28
Start date
2012-02-29
Completion date
2012-10-31
Last updated
2013-12-25

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Gas Exchange, Inverse-ratio Ventilation, Lung Cancer, One Lung Ventilation

Keywords

one lung ventilation, gas exchange, inverse-ratio ventilation

Brief summary

Pulmonary gas exchange disturbance is a common anesthetic problem during one-lung ventilation (OLV) for thoracic surgery. The inverse-ratio ventilation (IRV), which prolongs the inspiratory time greater than expiratory time, can be applied for adult respiratory distress syndrome. The effect of IRV is to improve gas-exchange status by increasing mean airway pressure and alveolar recruitment. We tried to evaluate the effect of IRV during OLV with lung protective strategy.

Detailed description

Pulmonary gas exchange disturbance is a common anesthetic problem during one-lung ventilation (OLV) for thoracic surgery. Continuous positive airway pressure or positive end-expiratory pressure are usually applied to improve this disorder including hypoxia, but these methods are not enough. The inverse-ratio ventilation (IRV), which prolongs the inspiratory time greater than expiratory time, can be applied for adult respiratory distress syndrome. The effect of IRV is to improve gas-exchange status by increasing mean airway pressure and alveolar recruitment. The application of IRV during OLV has not been performed to our knowledge, and there is a possibility of IRV to improve oxygenation during OLV. There is a possibility of increase of auto-PEEP, or air trapping in subjects with chronic obstructive pulmonary disease, but this kind of auto-PEEP can be overcome by external PEEP. Therefore, we tried to evaluate the effect of IRV during OLV with lung protective strategy.

Interventions

conventional I:E ratio of 1:2 is applied. Ventilator : Datex-Ohmeda Aestiva/5 ® model

OTHERI:E = 1:1 ratio

I:E ratio of 1:1 is applied Ventilator : Datex-Ohmeda Aestiva/5 ® model

Sponsors

Samsung Medical Center
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
DOUBLE (Subject, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

* patients undergoing elective lung lobectomy surgery. * the duration of one-lung ventilation is more than one hour. * subjects with more than twenty years old.

Exclusion criteria

* subjects with past history of pneumothorax, asthma * Age under 20, more than 70 years. * Patients with ischemic heart disease, valvular heart disease * patients with hemodynamic unstability

Design outcomes

Primary

MeasureTime frameDescription
arterial CO2 partial pressure10 minutes after induction of general anesthesiaarteial CO2 partial pressure

Secondary

MeasureTime frameDescription
arterial O2 partial pressure10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation, 1 hour after the end of surgeryarterial O2 partial pressure
Mean airway pressure10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilationMean airway pressure
tidal volume (exhaled)10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilationtidal volume (exhaled)
hemodynamic parameters10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilationsystolic/ diastolic blood pressure, heart rate, mean blood pressure
end-tidal CO2 partial pressure10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilationend-tidal CO2 partial pressure
respiratory compliance10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilationDynamic compliance, Static compliance
Dead space10 min after induction, 30 and 60 min after start of one lung ventilation, 15 min after restart of two-lung ventilationphysiologic dead space / tidal volume (VD/VT)
work of breathing10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilationwork of breathing
peak inspiratory pressure10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilationpeak inspiratory pressure
plateau pressure10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilationplateau pressure
positive end-expiratory pressure10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilationpositive end-expiratory pressure
minute ventilation10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilationminute ventilation

Countries

South Korea

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026