Effects of Positive End-Expiratory Pressure on Biventricular Function During One-Lung Ventilation

Effects of Positive End-Expiratory Pressure on Biventricular Function During One-Lung Ventilation: a Randomized Crossover Study

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT02483806

Enrollment

Registered

2015-06-29

Start date

2015-06-29

Completion date

2016-05-25

Last updated

2017-12-28

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

Conditions

Lung Cancer

Brief summary

One lung ventilation (OLV) is essential during thoracic surgery. During OLV, intrapulmonary shunt can be increased resulting hypoxemia. Wang et al measured intrapulmonary shunt by transesophageal echocardiography. Although OLV technique had been advanced so far, hypoxemia during OLV reaches about 10% in spite of inspired oxygen fraction 100%. Applying PEEP(Positive End-expiratory Pressure) at dependent lung and CPAP at non-dependent lung can mitigate the hypoxemia. Above all, PEEP can be easily applicable. However, there are controversial studies whether it is supportive or not. In this prospective, cross-over study, the investigators are planning to investigate the effects of PEEP on intrapulmonary shunt, oxygenation and cardiac function as well.

Interventions

PROCEDUREPEEP

After induction of anesthesia, including insertion of TEE probe, change position from supine to lateral position. Measure ABGA and cardiac indices for the baseline value. Apply each PEEP (0, 5, 10 cmH2O) serially at the random order. 6 sequences (0-\>5-\>10, 0-\>10-\>5, 5-\>10-\>0, 5-\>0-\>10, 10-\>5-\>0, 10-\>0-\>5) are equally applied to 6 patients (total 6x6=36 patients) who agreed to this study. Measure ABGA and cardiac indices after 20 min at each step of peep apply(3 times).

Study design

Allocation

RANDOMIZED

Intervention model

CROSSOVER

Primary purpose

DIAGNOSTIC

Masking

DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender

ALL

Age

40 Years to 80 Years

Healthy volunteers

Inclusion criteria

* scheduled for VATS lobectomy * 40 ≤ age ≤ 80 * American Society of Anaesthesiologists(ASA) physical status classification I\ III

Exclusion criteria

* American Society of Anaesthesiologists(ASA) physical status classification IV * NYHA class III\ IV * Severe obstructive lung disease and/or restrictive lung disease patients * those with end-organ diseases (i.e. heart failure, respiratory failure, hepatic failure, renal failure) * arrhythmia * esophageal varix * pregnant women

Design outcomes

Primary

Measure	Time frame	Description
the effect of differential PEEP (0, 5, 10 cmH2O) by PaO2(P/F ratio)	20 minutes after each PEEP apply	—
Cardiac function	20 minutes after each PEEP apply	cardiac function : Tei index

Countries

South Korea

Outcome results

None listed

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