Acidosis, Hypercapnia, Mechanical Ventilation, One Lung Ventillation (OLV), Smartphone Application, Surgery, Thoracic
Conditions
Brief summary
One-lung ventilation is a mechanical ventilation method frequently used during several thoracic surgeries. One-lung ventilation requires the use of protective ventilation to limit ventilator-induced injury and reduce postoperative respiratory complications. Protective ventilation during one-lung ventilation is specific since tidal volumes are applied by definition to one lung, and it is recommended to use lower tidal volumes, down to 4 ml/kg of ideal body weight. This approach requires individualized ventilation parameters, which differs from the conventional or two-lung ventilation, and there are no clear recommendations regarding respiratory rate adjustment to ensure adequate gas exchange.
Detailed description
The aim of the study is to: 1. Evaluate whether the initial ventilation settings (tidal volume and respiratory rate) during one-lung ventilation are appropriate to prevent respiratory acidosis. 2. Compare the ventilation settings (tidal volume and respiratory rate) made by clinicians with those proposed by an smartphone application ''VentilO''.
Interventions
OTHERone lung ventilation
Arterial blood gases during one lung ventilation
Sponsors
Laval University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Adults (≥ 18 years old) * Patients intubated and undergoing one-lung ventilation during thoracic surgery * Volume-controlled ventilation mode used intraoperatively
Exclusion criteria
* Arterial blood gas data unavailable during one-lung ventilation * Missing demographic data (sex, height, actual weight)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory acidosis | 20 minutes after initiation of one lung ventilation after lung isolation | The frequency of respiratory acidosis on arterial blood gases after 20 minutes of mechanical ventilation (pH \< 7.35 and PaCO2 \> 45mmHg) measured by arterial blood gases |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Acid-base disorder | At the beginning of one lung ventilation during the surgery | Presence of Respiratory alkalosis define by pH\>7.45 and PaCO2 \< 35 mmHg |
| Number of participants with hemodynamic shock - hypotension | Day 1 | Requiring \>1L of volume repletion and/or use of amines at \>0.05 mcg/kg/min or norepinephrine equivalent |
| Respiratory rate | At the beginning of one lung ventilation during the surgery | Respiratory rate set by the doctor, this respiratory rate will be compared to the suggestion of the algorithm |
| Mechanical Ventilation duration | Up to 90 days | Time spent with invasive mechanical ventilation during surgery and hospital stay |
| Hospital mortality | Up to 90 days | Occurence of death during hospital stay |
| Hospital length of stay | Up to 90 days | Recovery room admission through hospital discharge |
Countries
Canada
Contacts
Primary ContactFrancois Lellouche
Outcome results
None listed