The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing One-lung Ventilation for Lung Surgery

Not Applicable

Completed

• Conditions: Lung Cancer; One Lung Ventilation; Gas Exchange; Inverse-ratio Ventilation

• Registration Number: NCT01540201
• Lead Sponsor: Samsung Medical Center

Brief Summary

Pulmonary gas exchange disturbance is a common anesthetic problem during one-lung ventilation (OLV) for thoracic surgery. The inverse-ratio ventilation (IRV), which prolongs the inspiratory time greater than expiratory time, can be applied for adult respiratory distress syndrome. The effect of IRV is to improve gas-exchange status by increasing mean airway pressure and alveolar recruitment. We tried to evaluate the effect of IRV during OLV with lung protective strategy.

Detailed Description

Pulmonary gas exchange disturbance is a common anesthetic problem during one-lung ventilation (OLV) for thoracic surgery. Continuous positive airway pressure or positive end-expiratory pressure are usually applied to improve this disorder including hypoxia, but these methods are not enough. The inverse-ratio ventilation (IRV), which prolongs the inspiratory time greater than expiratory time, can be applied for adult respiratory distress syndrome. The effect of IRV is to improve gas-exchange status by increasing mean airway pressure and alveolar recruitment. The application of IRV during OLV has not been performed to our knowledge, and there is a possibility of IRV to improve oxygenation during OLV. There is a possibility of increase of auto-PEEP, or air trapping in subjects with chronic obstructive pulmonary disease, but this kind of auto-PEEP can be overcome by external PEEP. Therefore, we tried to evaluate the effect of IRV during OLV with lung protective strategy.

Study Timeline

• Study Start: 2012-02
• Study First Submitted: 2012-02-16
• Study First Submitted QC: 2012-02-27
• Study First Posted: 2012-02-28
• Primary Completion: 2012-10
• Study Completion: 2012-10
• Status Verified: 2013-12
• Last Update Submitted: 2013-12-24
• Last Update Posted: 2013-12-25

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 110

Inclusion Criteria

• patients undergoing elective lung lobectomy surgery.
• the duration of one-lung ventilation is more than one hour.
• subjects with more than twenty years old.

Exclusion Criteria

• subjects with past history of pneumothorax, asthma
• Age under 20, more than 70 years.
• Patients with ischemic heart disease, valvular heart disease
• patients with hemodynamic unstability

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
arterial CO2 partial pressure	1 hour after the end of surgery	arteial CO2 partial pressure

Secondary Outcome Measures

Name	Time	Method
arterial O2 partial pressure	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation, 1 hour after the end of surgery	arterial O2 partial pressure
Mean airway pressure	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation	Mean airway pressure
tidal volume (exhaled)	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation	tidal volume (exhaled)
hemodynamic parameters	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation	systolic/ diastolic blood pressure, heart rate, mean blood pressure
end-tidal CO2 partial pressure	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation	end-tidal CO2 partial pressure
respiratory compliance	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation	Dynamic compliance, Static compliance
Dead space	10 min after induction, 30 and 60 min after start of one lung ventilation, 15 min after restart of two-lung ventilation	physiologic dead space / tidal volume (VD/VT)
work of breathing	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation	work of breathing
plateau pressure	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation	plateau pressure
positive end-expiratory pressure	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation	positive end-expiratory pressure
minute ventilation	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation	minute ventilation
peak inspiratory pressure	10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation	peak inspiratory pressure

Trial Locations

Locations (1)

Samsung Medical Center; 🇰🇷 Seoul, Korea, Republic of