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Clinical Trials/NCT03728010
NCT03728010
Recruiting
Not Applicable

Tidal Volume and PEEP Titration in One-Lung Ventilation With Electrical Impedance Tomography

University of Chile1 site in 1 country20 target enrollmentDecember 7, 2018
ConditionsVentilator Lung

Overview

Phase
Not Applicable
Intervention
Not specified
Conditions
Ventilator Lung
Sponsor
University of Chile
Enrollment
20
Locations
1
Primary Endpoint
Pulmonary mechanics
Status
Recruiting
Last Updated
2 years ago

Overview

Brief Summary

Mechanical ventilation can cause damage to the lung parenchyma, this is known as ventilatory induce lung injury (VILI).To avoid this damage, ventilatory strategies have been created, focused on the reduction of tidal volume, airway pressures and use of PEEP (positive end-expiratory pressure), which together are called "protective ventilation".

Although ventilation with protective parameters seems to reduce VILI in one-lung ventilation, the optimal parameters are not clear.

Detailed Description

This research aims to describe the ventilation, perfusion and pulmonary mechanics on one-lung ventilation with different levels of tidal volume and PEEP. An extreme situation of VILI occurs in thoracic surgery, where the atelectasis of a lung is required, ventilating throughout the surgery only the contralateral one. This generates an inflammatory state, with the release of alveolar cytokines from both the non-ventilated and ventilated lungs, which potentiates the development of damage in the lung parenchyma. In addition, one lung ventilation has traditionally been performed with high tidal volume (Vt) values and low PEEP. In this context, the development of VILI is even more probable, so extreme measures of protection in this kind of ventilation are necessary. The electrical impedance tomography will allow the investigators to obtain a visual and quantitative representation of the areas of ventilation and perfusion of the lung. By relating the tidal volume and PEEP with the tomographic results, it is expected to define mechanical ventilation parameters that achieve the best ventilation/perfusion ratio for patients in one-lung ventilation. Specifically, analyze the distribution and deformation of the ventilated areas in the different lung regions and its correlation with respiratory mechanics and volumetric capnography. This will allow the investigators to make a better definition of the tidal volume and PEEP in patients undergoing one-lung ventilation. .

Registry
clinicaltrials.gov
Start Date
December 7, 2018
End Date
January 2024
Last Updated
2 years ago
Study Type
Observational
Sex
All

Investigators

Sponsor
University of Chile
Responsible Party
Principal Investigator
Principal Investigator

Roberto Gonzalez Cornejo

Anesthesiologist

University of Chile

Eligibility Criteria

Inclusion Criteria

  • ASA (American Society of Anesthesiologists) classification I-III
  • Age 18-75 Years
  • Elective thoracic surgery
  • One-Lung Ventilation
  • Healthy non ventilated lung

Exclusion Criteria

  • ASA classification \> III
  • BMI (Body mass index) \> 30
  • Emergency surgery
  • Pregnancy
  • Patients includes in other protocols

Outcomes

Primary Outcomes

Pulmonary mechanics

Time Frame: 1 hour

Airway pressure ,esophageal pressure measurement.

Ventilation/ perfusion ratio

Time Frame: 1 hour

Electrical impedance tomography.

Arterial gas measurement

Time Frame: 20 minutes

5 samples per patient

Study Sites (1)

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