Reperfusion Injury After Pulmonary Thromboendarterektomy
Conditions
Keywords
Chronic thromboembolic pulmonary hypertension, PEEP, reperfusion injury
Brief summary
Investigation of the effect of intraoperative lung protection high PEEP maneuver on ischemic reperfusion injury in patients undergoing pulmonary endarterectomy.
Detailed description
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease characterized by progression of thromboembolism obstructing pulmonary arteries as an organized tissue. Pulmonary thromboendarterectomy (PTE) is a treatment option for chronic thromboembolic pulmonary disease. However, PTE is associated with specific postoperative complications, such as pulmonary edema and right ventricular failure due to reperfusion injury, with a significant mortality rate of 7% to 24%. Some strategies have been proposed to reduce lung injury after PTE, such as rectification maneuvers and high PEEP. The aim of this study was to investigate the effect of intraoperative lung protection high PEEP maneuver in patients undergoing pulmonary endarterectomy for ischemic reperfusion injury.
Interventions
OTHERPEEP
performing 35 cm/H2O PEEP and 2-3 ml/kg tidal volume
OTHERcontrol group
performing 6 cm/H2O PEEP and 6-8 ml/kg tidal volume
Sponsors
Kartal Kosuyolu Yuksek Ihtisas Education and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)
Intervention model description
prospective, randomized
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Patients undergoing elective PTE operation due to CTEPH, * 20-70 years old
Exclusion criteria
* Patients with chronic inflammatory disease, * liver and renal failure, * heart failure (\<EF: 40%), * intraoperative bronchial hemorrhage, * patients undergoing postoperative revision.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| free oxygen radicals levels | 48 hours | Superoxide dismutase (SOD) activity will be measured by modification of the method of Sun et al. and Protein carbonyl groups will be determined by volume modification according to Reznick and Packer method. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| postoperatif outcome - Duration of stay in the intensive care unit and hospital stay | 10 day | Duration of stay in the intensive care unit and hospital stay after pte operation |
Countries
Turkey (Türkiye)
Outcome results
None listed