Diaphragm Injury, Phrenic Nerve Paralysis, Postoperative Complications, Thoracic Cancer
Conditions
Brief summary
This study aims to measure diaphragmatic dysfunction with ultrasonography and nerve stimulation of the phrenicus nerve, in patients undergoing thoracic surgery for lung and esophageal cancer, and correlate measures of diaphramatic function to clinical postoperative endpoints.
Interventions
PROCEDURELung lobectomy OR esophagus cancer resection
Lunge lobectomy (total) Resection of esophagus cancer
Sponsors
Aarhus University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Scheduled thoracic resection Surgery for lung- or esophagus cancer. For lung cancer patients, at least one lung lobe has to scheduled for resection
Exclusion criteria
* Known Diaphragmatic Dysfunction * Neuromuscular Disease * Pleural Effusion \> 1cm * Pneumothorax * Known Phrenic Nerve Palsy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in excursion of the diaphragm | Prior to surgery to 14 days after surgery | Ultrasonographic measure with M-mode of Diaphragmatic Excursion on right hemidiaphragm |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Ultrasonographic measure of the difference in Intrathoracic Area | Prior to surgery to 14 days after surgery | Intrathoracic Area is measured at inspiration and expiration to calculate the difference in Intrathoracic Area during breathing |
| Change in Diaphragmatic Thickening Fraction | Prior to surgery to 14 days after surgery | Ultrasonographic measurement |
| Change in Intercostal Muscle Thickening Fraction | Prior to surgery to 14 days after surgery | Ultrasonographic measurement |
| Change in forced expired volume within the first second (FEV1) | Prior to surgery to 14 days after surgery | Spirometry |
| Change in forced vital capacity (FEV) | Prior to surgery to 14 days after surgery | Spirometry |
| Change in peak flow | Prior to surgery to 14 days after surgery | Spirometry |
| Change in Electromyographic measure of Maximal Diaphragmatic Response after stimulating the phrenic nerve | Prior to surgery to 14 days after surgery | — |
| Accumulated Admission Days at any Hospital | Prior to surgery to 60 days after surgery | — |
| Change in 6 Minutes Walk Test | Prior to surgery to 14 days after surgery | Maximum Walking Distance within 6 minutes |
| Change in visual analogue scale score | Prior to surgery to 14 days after surgery | Scoring system for subjective sensation of pain ranging from 0 to 10. Higher numbers signify higher pain sensations |
| Accumulated Opiod Use after Surgery | Prior to surgery to 14 days after surgery | Morphine equivalents |
| Postoperative Pulmonary Complications | Prior to surgery to 30 days after surgery | Comprising: 1. Pneumonia 2. Atelectasis 3. Bronchospasm 4. Hypoxemia 5. Severe Hypoxemia 6. Pleural Effusion 1 \> cm 7. Pneumothorax 8. CPAP or NIV required after 1. postoperative day |
| Admission days at the Intensive Care Unit after Surgery | Prior to surgery to 60 days after surgery | — |
| Number of Admissions after Discharge from the Surgical Department | Prior to surgery to 60 days after surgery | — |
| Change in Electromyographic measure of Latency of Diaphragmatic Response after stimulating the phrenic nerve | Prior to surgery to 14 days after surgery | — |
Countries
Denmark
Outcome results
None listed