Effectiveness of Lung Sono in One-lung Ventilation

Not Applicable

Completed

• Conditions: One Lung Ventilation
• Interventions: Procedure: Lung-sono guided

• Registration Number: NCT03770793
• Lead Sponsor: Seoul National University Hospital

Brief Summary

To observe the effectiveness of ultrasound-guided alveolar recruitment in thoracic surgery with one-lung ventilation(OLV).

Detailed Description

One-lung ventilation(OLV) is essential in thoracic surgery for patient safety and better surgical view. However, pulmonary complications such as hypoxemia may be caused by OLV which might be preventable with adequate alveolar recruitment and positive end-expiratory pressure(PEEP). Alveolar recruitment has been performed with conventional methods without diagnostic tools in clinical setting.

Ultrasound is a non-invasive, radiation-free device with high accuracy for the diagnosis of lung atelectasis. There are a few reports regarding the usefulness of lung ultrasound in other surgeries, but not in thoracic surgeries with OLV.

Thus, investigators designed a study to observe the effectiveness of ultrasound-guided alveolar recruitment in thoracic surgery with OLV.

Study Timeline

• Study First Submitted: 2018-12-06
• Study First Submitted QC: 2018-12-06
• Study Start: 2018-12-07
• Study First Posted: 2018-12-10
• Primary Completion: 2019-05-07
• Study Completion: 2019-05-07
• Status Verified: 2020-11
• Last Update Submitted: 2020-11-09
• Last Update Posted: 2020-11-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 166

Inclusion Criteria

• Elective thoracic surgery which requires one-lung ventilation with lateral decubitus position

Exclusion Criteria

• Patients who refuse to agree
• Previous lung surgical history
• History of pneumothorax or bullae
• Severe cardiopulmonary disease, COPD
• Operation time < 1hr

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Lung-sono guided	Lung-sono guided	Before starting one-lung ventilation, alveolar recruitment is performed under the examination with ultrasound. Find the minimal airway pressure that actually starts to resolve the observed atelectasis. Repeat alveolar recruitment with the minimal pressure untill the atlelectasis is not visible.

Primary Outcome Measures

Name	Time	Method
P/F ratio	30 minutes after one-lung ventilation	PaO2/FiO2 ratio
Incidence of desaturation	intraoperative	SpO2\<95%

Secondary Outcome Measures

Name	Time	Method
Lung ultrasound score	just after anesthesia induction, end of surgery	Lung ultrasound score of atelectasis
Alveolar dead space	30 minutes after one-lung ventilation	(PaCO2-PetCO2)xVt/PaCO2
Pulmonary complications	intraoperative, during hospital stay(an average of 3 days)	respiratory infection, respiratory failure, pleural effusion, atelectasis, pneumothorax, atelectasis, bronchospasm, aspiration pneumonitis

Trial Locations

Locations (1)

Seoul National University Hospital; 🇰🇷 Seoul, Korea, Republic of