The Effect of Permissive Hypercapnia on Oxygenation and Post-operative Pulmonary Complication During One-lung Ventilation
- Conditions
- Thoracic Surgery
- Interventions
- Other: group 50Other: group 60Other: group 40
- Registration Number
- NCT04175379
- Lead Sponsor
- Yonsei University
- Brief Summary
Permissive hypercapnia increased the survival rate in patients with acute respiratory distress syndrome (ARDS) who required mechanical ventilation in critical care medicine. This has been explained by its association with ventilator induced lung injury. Since then, a protective lung ventilation strategy has been very important, with a low tidal volume of 4-6 ml/kg. Patients undergoing surgery will inevitably require mechanical ventilation. In particular, patients undergoing one lung ventilation for thoracic surgery may have increased airway pressure and a greater chance of ventilator induced lung injury. Recently, protective lung ventilation has been applied to patients undergoing one ung ventilation during thoracic surgery. The purpose of this study is to evaluate the difference in the degree of pulmonary oxygenation and the incidence of postoperative pulmonary complications in hypercapnia induced by controlling the respiratory rate with a constant tidal volume.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 279
- Adult patients aged 40-80 years who are planning to have thoracoscopic single lobectomy or segmentectomy with one lung ventilation during surgery.
- American Society of Anesthesiologists (ASA) classification 1~3
- patients with heart failure (NYHA class III~IV)
- patients who are having moderate obstructive lung disease or restrictive lung disease
- Low DLCO (< 75%)
- patients with brain disease history or increased ICP
- patients with pulmonary hypertension (mean PAP>25mmHg)
- patients with liver disease (AST level ≥100 IU/mL or ALT ≥ level 50 IU/L) or kidney disease (Creatine level ≥ 1.5 mg/dL)
- patients with pre-existing hypercapnia or metabolic acidosis
- body mass index (BMI) > 30 kg/m2
- patients who have had contralateral lung surgery
- patients who cannot read explanation and consent form
- patients who are pregnant
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description group 50 group 50 In group 50, target PaCO2 is 50 during surgery group 60 group 60 In group 60, target PaCO2 is 60 during surgery group 40 group 40 In group 40, target PaCO2 is 40 during surgery
- Primary Outcome Measures
Name Time Method PaO2/FiO2 ratio about 60 minutes after reaching to the target PaCO2 (T2) (arterial oxygen partial pressure / fractional inspired oxygen) at the time of T2 (PaO2 of ABGA/FiO2) T2
- Secondary Outcome Measures
Name Time Method Post-op complication: desaturation event first 3 days after surgery desaturation event (\<90%) the first 3 days after surgery
Post-op complication: hospitalized days 30 days after surgery length of hospitalized stays CU days, expire
Post-op complication: oxygen therapy first 2~7 days after surgery necessity of oxygen therapy within the first 2\~7 days after surgery hospitalized days, ICU days, expire
Post-op complication 30 days after surgery The presence or absence of post operative complication like pneumonia, acute lung injury, re-intubation, ICU admission, ventilator care, empyema, broncho-pleura fistula, air-leakage, pleural effusion, pulmonary embolism, tracheostomy, wound infection, AKI, MI, etc.
Post-op complication: ICU days 30 days after surgery length of ICU stays
Dead 30 days after surgery patient has been dead or not
Trial Locations
- Locations (1)
Department of Anaesthesiology and Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine
🇰🇷Seoul, Korea, Republic of