COPD, One Lung Ventilation
Conditions
Brief summary
COPD is often associated with the airflow limitation and the pulmonary hyperinflation. During the one-lung ventilation (OLV), COPD patients' physiologic dead space increases and hypercapnia may develop. In addition, an alveolar overdistention by the pulmonary hyperinflation would divert pulmonary blood flow and impair arterial oxygenation. Dexmedetomidine has both vasoconstricting and vasodilatatory effects on a peripheral vasculature and a smooth muscle but its effects on bronchial smooth muscle is unknown. The investigators will evaluate the effects of dexmedetomidine (bolus of 1.0 μg kg-1 over 10 min followed by a continuous infusion at 0.5 μg kg-1 h-1 infusion during one-lung ventilation) as bronchodilator in COPD patients when administered during surgery with the one lung ventilation. If result successfully shows the effect of dexmedetomidine as a predominantly a vasodilator on bronchial tree, the investigators study can support the dexmedetomidine as a vasodilator for pulmonary vessels and bronchial smooth muscle and as an excellent adjunct to anesthetic agents in COPD patients during the OLV.
Interventions
DRUGsaline infusion
saline infusion, bolus of 1.0 μg kg-1 over 10 min followed by a continuous infusion at 0.5 μg kg-1 h-1 infusion during one-lung ventilation, intravenous
DRUGdexmedetomidine infusion
dexmedetomidine, bolus of 1.0 μg kg-1 over 10 min followed by a continuous infusion at 0.5 μg kg-1 h-1 infusion during one-lung ventilation, intravenous
Sponsors
Yonsei University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
40 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
1. Above 40 years of age 2. American Society of Anesthesiologists (ASA) Physical Status I, II, III. 3. COPD diagnosed , criteria ( on preop. PFT : FEV1 \< 80%, FEV1 / FVC \< 70% after bronchodilator) 4. thoracic surgical procedure
Exclusion criteria
1. severe functional liver or kidney disease 2. diagnosed HF ( NYHA class \>3) 3. arrhythmia or received treatment with antiarrythmic drug . 4. exceed BMI \> 30 kg/ m2 5. bradycardia (HR \<50 bpm)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The change of the oxygenation | At two-lung ventilation (T1) , 20 min after of one-lung ventilation (T2), 30 mins after Dex or placebo saline infusion (T3), 60 mins after Dex or placebo saline infusion (T4), at the termination of surgery in TLV (T5) | PaO2/FiO2 ratio |
Outcome results
None listed