One Lung Ventilation, Thoracic Surgery, Ventilator-Induced Lung Injury
Conditions
Brief summary
It is controversial as to which ventilation mode is better in one-lung ventilation(OLV), volume controlled ventilation(VCV) or pressure controlled ventilation(PCV). This study was designed to figure out if there was any difference between these two modes on oxygenation and postoperative complications under the condition of protective ventilation(PV).
Detailed description
This is a single center, single blinded prospective study on two different ventilation mode during one lung ventilation for patients under video assistant thoracoscopy(VATS) lobectomy. After institutional approval and written informed consent were obtained, 60 patients with primary lung cancer under VATS lobectomy in Zhongshan Hospital Fudan University were enrolled and randomized into two groups:VCV group(group V) or PCV group(group P). Inclusion criteria were age between 18-75 years , ASA I-II, lateral decubitus position with at least 1h OLV and preoperative FEV1\>50% predicted. Preoperative exclusion criteria were previous lobectomy , COPD , asthma, uncompensated cardiac disease or contraindications for epidural catheter. Intraoperative exclusion criteria were SpO2 under 90% after intratracheal suction, reconfirmation the position of double lumen tracheal tube(DLT) and recruitment maneuver of dependant lungs.
Interventions
OTHERVCV mode
set fixed 6ml/kg tide volume
OTHERPCV mode
adjust pressure to achieve tide volume of 6ml/kg
Sponsors
Shanghai Zhongshan Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* ASA I-II, lateral decubitus position with at least 1h OLV and preoperative FEV1\>50% predicted
Exclusion criteria
* Preoperative
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Airway pressure Ppeak | during procedure | Airway pressure Ppeak in cmH2O. |
| Airway pressure Pplat | during procedure | Airway pressure Pplat in cmH2O. |
| oxygenation index | during procedure | Oxygenation index is calculated by PaO2/FiO2. PaO2 is measured by blood-gas analysis in mmHg. FiO2 is measured by gas monitor. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| postoperative complications | within 30 days after surgery | including air leak, pneumonia, bronchopleural fistula, respiratory failure, ARDS, reintubation, tracheostomy, pulmonary embolism, arrhythmia requiring treatment, myocardial infarction, renal dysfunction, central neurologic event, sepsis, unexpected return to operating room, unexpected ICU admission and mortality within 30 days |
Countries
China
Outcome results
None listed