Lung Cancer
Conditions
Brief summary
One lung ventilation (OLV) is essential during thoracic surgery. During OLV, intrapulmonary shunt can be increased resulting hypoxemia. Although OLV technique had been advanced so far, hypoxemia during OLV reaches about 10% in spite of inspired oxygen fraction 100%. Iloprost is a prostaglandin analogue used for pulmonary hypertension, which can decrease pulmonary artery resistance by selectively dilating pulmonary artery. In this prospective, randomized, double blind study, investigators are planning to investigate the effects of iloprost on respiratory physiology (intrapulmonary shunt, deadspace, oxygenation, etc).
Interventions
DRUGiloprost
20μg(2ml) of inhaled iloprost (Ventavis®) When anesthesia induction finishes, change patients' position from supine to lateral position and measure arterial blood gas analysis (ABGA), venous blood gas analysis (VBGA) while two lung is ventilated. After 20 minutes of applying one lung ventilation, measure ABGA. Apply iloprost or normal saline inhalation for each iloprost and control group and measure ABGA at the time of 20 min and 40 min after iloprost (or normal saline) inhalation has finished.
DRUGnormal saline
20μg(2ml) of inhaled normal saline When anesthesia induction finishes, change patients' position from supine to lateral position and measure ABGA, VBGA while two lung is ventilated. After 20 minutes of applying one lung ventilation, measure ABGA. Apply iloprost or normal saline inhalation for each iloprost and control group and measure ABGA at the time of 20 min and 40 min after iloprost (or normal saline) inhalation has finished.
Sponsors
Yonsei University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
40 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* scheduled for Video-assisted thoracoscopic surgery (VATS) lobectomy * 40 \< age \< 80 * American Society of Anaesthesiologists (ASA) physical status classification I\ III * diffusing capacity (DLCO) \<75% at pre op. pulmonary function test
Exclusion criteria
* American Society of Anaesthesiologists (ASA) physical status classification IV * New York Heart Association (NYHA) class III\ IV * Severe obstructive lung disease and/or restrictive lung disease patients * patients with end-organ diseases (i.e. heart failure, respiratory failure, hepatic failure, renal failure) * arrhythmia * pregnant women * disease that can influence the DLCO result (anemia, pulmonary vascular disease)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| PaO2(partial pressure of arterial oxygen) ratio | 40 minutes after iloprost inhalation |
| incidence of intrapulmonary shunt | 40 minutes after iloprost inhalation |
Countries
South Korea
Outcome results
None listed