Patients Scheduled for Brain Surgery
Conditions
Brief summary
Mechanical respiration during general anesthesia causes cold and dry gases to reach the lower airway, reduce the function of the airway mucosa, and cause accumulation of secretions. Inhaled dry gas is one of the causes of hypothermia during general anesthesia. To overcome this, the warm-humidifying breathing circuit uses warm, moisture-preserving gas to promote mucus mobility of the airway mucosal ciliate cells and prevents cold gases from evaporating from the mucosal surfaces which results lowering body temperature. We aimed to investigate the effect of newly developed Sohum warm humidifying respiration circuit (SH501) on the prevention of core body temperature reduction during surgery and systemic inflammation reaction.
Interventions
DEVICEconventional circuit
The patient enters the operating room without any pretreatment and attaches a standard patient monitoring device. Anesthesia was performed by intravenous anesthesia. After induction of anesthesia, alveolar recruitment is performed in supine position in all groups with 30 cmH2O for 5 seconds. Mechanical ventilator was set with tidal volume of 8 ml / kg, the inspiratory/ expiratory ratio of 1: 2 and respiratory rate was adjusted for targeting EtCO2 around 35mmHg. Keep the fresh air flow of the ventilator at 3 L / min and set the temperature to 37 ° C for the heating circuits of group H and group SH. An arterial cannulation and subclavian jugular vein catheter is inserted. The circuits were applied to each group as follows; conventional circuit or group C, conventional humidification circuit for group H and new humidification heat circuit for group SH, respectively. All other conditions were same among three groups.
DEVICEconventional humidification circuit
The patient enters the operating room without any pretreatment and attaches a standard patient monitoring device. Anesthesia was performed by intravenous anesthesia. After induction of anesthesia, alveolar recruitment is performed in supine position in all groups with 30 cmH2O for 5 seconds. Mechanical ventilator was set with tidal volume of 8 ml / kg, the inspiratory/ expiratory ratio of 1: 2 and respiratory rate was adjusted for targeting EtCO2 around 35mmHg. Keep the fresh air flow of the ventilator at 3 L / min and set the temperature to 37 ° C for the heating circuits of group H and group SH. An arterial cannulation and subclavian jugular vein catheter is inserted. The circuits were applied to each group as follows; conventional circuit or group C, conventional humidification circuit for group H and new humidification heat circuit for group SH, respectively. All other conditions were same among three groups.
DEVICEnew humidifaction heat circuit
The patient enters the operating room without any pretreatment and attaches a standard patient monitoring device. Anesthesia was performed by intravenous anesthesia. After induction of anesthesia, alveolar recruitment is performed in supine position in all groups with 30 cmH2O for 5 seconds. Mechanical ventilator was set with tidal volume of 8 ml / kg, the inspiratory/ expiratory ratio of 1: 2 and respiratory rate was adjusted for targeting EtCO2 around 35mmHg. Keep the fresh air flow of the ventilator at 3 L / min and set the temperature to 37 ° C for the heating circuits of group H and group SH. An arterial cannulation and subclavian jugular vein catheter is inserted. The circuits were applied to each group as follows; conventional circuit or group C, conventional humidification circuit for group H and new humidification heat circuit for group SH, respectively. All other conditions were same among three groups.
Sponsors
Yonsei University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. age ≥ 19 2. scheduled for brain surgery
Exclusion criteria
1. age \< 19 2. patients with severe obstructive lung disease and/or restrictive lung disease patients 3. patients with infectious disease 4. surgery with prone position or lateral position 5. arrhythmia
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| core temperature | every 30 minute after induction of anesthesia until the end of anesthesia |
| upper airway temperature | every 30 minute after induction of anesthesia until the end of anesthesia |
| upper airway humidity | every 30 minute after induction of anesthesia until the end of anesthesia |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| respiratory variables | every 30 minute after induction of anesthesia until the end of anesthesia | mmHg for respiratory variables(PaO2, PaCO2, PvO2, PvCO2) |
| cytokine level | 1, 30, 60, 90, 120, 150, 180, 210, 240 minute after induction and 1 second after the operation | pg/ml for Cytokine level(TNF-a, IL-1, IL-6, IL-8, IL-10) |
| compliance | every 30 minute after induction of anesthesia until the end of anesthesia | L/cmH2O for compliance(△V/△P) |
| dead space | every 30 minute after induction of anesthesia until the end of anesthesia | % for Deadspace(Vd/Vt) |
| intrapulmonary shunt | every 30 minute after induction of anesthesia until the end of anesthesia | Qs/Qt, |
Countries
South Korea
Contacts
Primary ContactYong Seon Choi, MD
Outcome results
None listed