The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing One-lung Ventilation for Lung Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 110
- 试验地点
- 2
- 主要终点
- arterial CO2 partial pressure
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 20 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •patients undergoing elective lung lobectomy surgery.
- •the duration of one-lung ventilation is more than one hour.
- •subjects with more than twenty years old.
排除标准
- •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
结局指标
主要结局
arterial CO2 partial pressure
时间窗: 1 hour after the end of surgery
arteial CO2 partial pressure
次要结局
- 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)
- 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)
- 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)
- hemodynamic parameters(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(10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation)
- respiratory compliance(10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation)
- Dead space(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(10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation)
- plateau 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(10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation)
- minute ventilation(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(10 min after induction, 30 and 60 min after start of one-lung ventilation, 15 min after restart of two-lung ventilation)
研究者
Sangmin M. Lee
Professor
Samsung Medical Center