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Metabolomic Study in Exhaled Breath Condensate of Thoracic Surgical Patients

Conditions
Ventilator-associated Lung Injury
Acute Pulmonary Insufficiency Following Thoracic Surgery
Interventions
Procedure: Thoracic Surgery without Lung Resection
Procedure: Thoracic Surgery with Lung Resection
Registration Number
NCT02583984
Lead Sponsor
National Taiwan University Hospital
Brief Summary

Acute lung injury (ALI) following thoracic surgery remains a major source of morbidity and mortality after lung resection. One-lung ventilation (OLV) is usually required in thoracic surgery. OLV is also an important predictor of postoperative ALI. Recent laboratory findings suggested that tissue hypoxemia and ischemia / reperfusion injury of the collapsed lungs during OLV is the major cause of lung injury. Exhaled Breath Condensate (EBC), which is the exhalate from breath typically collected by cooling device, contains most molecules found in the airway. Metabolomics refers to systematic and scientific study of chemical processes involving metabolites. This study will collect EBC for metabolomic analysis and aim to elucidate the biochemical reactions during one-lung ventilation and pathological mechanisms of acute lung injury following thoracic surgery.

Detailed Description

Acute lung injury (ALI) following thoracic surgery remains a major source of morbidity and mortality after lung resection. Despite the advancement in both the surgical techniques and the perioperative management, the incidence of postoperative ALI remains remarkable. Risk factors for postoperative lung injury are evident, including preoperative pulmonary function, type of surgical procedure, intraoperative fluid management, one-lung ventilation, and ventilator settings. One-lung ventilation (OLV) is usually required in thoracic surgery. OLV is also an important predictor of postoperative ALI. Recent laboratory findings suggested that tissue hypoxemia and ischemia / reperfusion injury of the collapsed lungs during OLV is the major cause of lung injury. Exhaled Breath Condensate (EBC), which is the exhalate from breath typically collected by cooling device, contains most molecules found in the airway. EBC analysis has potential applications in lung disease, such as severity of airway inflammation in asthmatic patients. Collecting EBC is simple and non-invasive, in contrast to bronchoscopy for lung biopsy or bronchoalveolar lavage. Metabolomics refers to systematic and scientific study of chemical processes involving metabolites. This study will collect EBC from thoracic surgical patients before, during, and after OLV. The investigators will perform metabolomic analysis and aim to elucidate the biochemical reactions during one-lung ventilation and pathological mechanisms of acute lung injury following thoracic surgery.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Thoracic surgical patients requiring lung isolation
  • Pulmonary resection: lobectomy, segmentectomy
  • Esophageal surgery and no pulmonary resection
  • Mediastinal surgery and no pulmonary resection
Exclusion Criteria
  • Metabolic disorder
  • Metabolic syndrome
  • Diabetes
  • Pregnancy

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Thoracic Surgery without Lung ResectionThoracic Surgery without Lung ResectionGeneral anesthesia and lung separation Thoracic Surgery without Lung Resection, such as esophageal surgery, mediastinal surgery
Thoracic Surgery with Lung ResectionThoracic Surgery with Lung ResectionGeneral anesthesia and lung separation Thoracic Surgery with Lung Resection, such as lobectomy, segmentectomy
Primary Outcome Measures
NameTimeMethod
Number of participants with acute lung injury following thoracic surgery30 days
Secondary Outcome Measures
NameTimeMethod
Metabolome of exhaled breath condensate associated with lung injury in thoracic surgery5 hours

Trial Locations

Locations (1)

Department of Anesthesiology, National Taiwan University Hospital

🇨🇳

Taipei City, Taiwan

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