Effects of Dexmedetomidine on Respiratory Mechanics and Oxygenation During One Lung Ventilation With Chronic Obstructive Lung Disease
- Conditions
- COPD, One Lung Ventilation
- Interventions
- Drug: dexmedetomidine infusionDrug: 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
- Above 40 years of age
- American Society of Anesthesiologists (ASA) Physical Status I, II, III.
- COPD diagnosed , criteria ( on preop. PFT : FEV1 < 80%, FEV1 / FVC < 70% after bronchodilator)
- thoracic surgical procedure
- severe functional liver or kidney disease
- diagnosed HF ( NYHA class >3)
- arrhythmia or received treatment with antiarrythmic drug .
- exceed BMI > 30 kg/ m2
- bradycardia (HR <50 bpm)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description dexmedetomidine group dexmedetomidine infusion dexmedetomidine Control group saline infusion saline solution
- Primary Outcome Measures
Name Time Method The change of the oxygenation At 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
Name Time Method