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Effects of Dexmedetomidine on Respiratory Mechanics and Oxygenation During One Lung Ventilation With Chronic Obstructive Lung Disease

Not Applicable
Completed
Conditions
COPD, One Lung Ventilation
Interventions
Drug: dexmedetomidine infusion
Drug: saline infusion
Registration Number
NCT02185430
Lead Sponsor
Yonsei University
Brief Summary

COPD is often associated with the airflow limitation and the pulmonary hyperinflation. During the one-lung ventilation (OLV), COPD patients' physiologic dead space increases and hypercapnia may develop. In addition, an alveolar overdistention by the pulmonary hyperinflation would divert pulmonary blood flow and impair arterial oxygenation. Dexmedetomidine has both vasoconstricting and vasodilatatory effects on a peripheral vasculature and a smooth muscle but its effects on bronchial smooth muscle is unknown. The investigators will evaluate the effects of dexmedetomidine (bolus of 1.0 μg kg-1 over 10 min followed by a continuous infusion at 0.5 μg kg-1 h-1 infusion during one-lung ventilation) as bronchodilator in COPD patients when administered during surgery with the one lung ventilation. If result successfully shows the effect of dexmedetomidine as a predominantly a vasodilator on bronchial tree, the investigators study can support the dexmedetomidine as a vasodilator for pulmonary vessels and bronchial smooth muscle and as an excellent adjunct to anesthetic agents in COPD patients during the OLV.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
63
Inclusion Criteria
  1. Above 40 years of age
  2. American Society of Anesthesiologists (ASA) Physical Status I, II, III.
  3. COPD diagnosed , criteria ( on preop. PFT : FEV1 < 80%, FEV1 / FVC < 70% after bronchodilator)
  4. thoracic surgical procedure
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Exclusion Criteria
  1. severe functional liver or kidney disease
  2. diagnosed HF ( NYHA class >3)
  3. arrhythmia or received treatment with antiarrythmic drug .
  4. exceed BMI > 30 kg/ m2
  5. bradycardia (HR <50 bpm)
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
dexmedetomidine groupdexmedetomidine infusiondexmedetomidine
Control groupsaline infusionsaline solution
Primary Outcome Measures
NameTimeMethod
The change of the oxygenationAt two-lung ventilation (T1) , 20 min after of one-lung ventilation (T2), 30 mins after Dex or placebo saline infusion (T3), 60 mins after Dex or placebo saline infusion (T4), at the termination of surgery in TLV (T5)

PaO2/FiO2 ratio

Secondary Outcome Measures
NameTimeMethod
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