Differential Lung Ventilation vs. CPAP

Not Applicable

Completed

• Conditions: Differential Lung Ventilation; Continuous Positive Airway Pressure; One Lung Ventilation
• Interventions: Device: cpap

• Registration Number: NCT03563612
• Lead Sponsor: Rambam Health Care Campus

Brief Summary

In this study we compared the efficacy of continuous positive airway pressure (CPAP) to differential lung ventilation, in terms of patient's oxygenation, during video assisted thoracoscopic lung resection.

Detailed Description

Background: One Lung Ventilation (OLV) is the technique used during lung resection surgery in order to facilitate optimal surgical conditions. OLV may result in hypoxemia due to the shunt created. Several techniques are used to overcome the hypoxemia, one of which is continuous positive airway pressure (CPAP) to the non-dependent lung. Another technique is ventilating the non-dependent lung with a minimal volume, thus creating differential lung ventilation (DLV). In this study we compared the efficacy of CPAP to DLV during video assisted thoracoscopic lung resection.

Patients and Method: This is a prospective study of 30 adult patients undergoing elective video assisted thoracoscopic lung lobectomy. Each patient was ventilated in four modes: two lung ventilation, OLV, OLV+CPAP and OLV+DLV. Fifteen patients were ventilated with CPAP first and DLV next, and the other 15 were ventilated with DLV first and then CPAP. Five minutes separated each mode, during which the non-dependent lung was open to room air. We measured the patient's arterial blood gas during each mode of ventilation. The surgeons, who were blinded to the ventilation technique, were asked to assess the surgical conditions at each stage.

Study Timeline

• Study Start: 2017-04-01
• Primary Completion: 2017-09-30
• Study Completion: 2017-09-30
• Study First Submitted: 2018-05-26
• Status Verified: 2018-06
• Study First Submitted QC: 2018-06-09
• Last Update Submitted: 2018-06-09
• Study First Posted: 2018-06-20
• Last Update Posted: 2018-06-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 29

Inclusion Criteria

1. Adult patients diagnised with lung cancer
2. Scheduled to have thoracoscopic lung lobectomy -

Exclusion Criteria

1. Pregnancy
2. ASA>=4
3. Difficult intubation -

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
differential ventilation first, cpap late	cpap	-
cpap first, differential ventilation later	cpap	-

Primary Outcome Measures

Name	Time	Method
arterial blood oxygenation	intraoperative	PaO2

Secondary Outcome Measures

Name	Time	Method
interference with surgical field exposure	intraoperative	interference
airway pressure in the dependent lung during one lung ventilation	intraoperative	airway pressure

Trial Locations

Locations (1)

Rambam Health Care Campus; 🇮🇱 Haifa, Israel