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Non-Invasive Ventilation Preoperative Lung Resection Surgery

Not Applicable
Completed
Conditions
Surgery for Primary Lung Cancer
Registration Number
NCT01685580
Lead Sponsor
University Hospital, Brest
Brief Summary

Surgical treatment is the standard treatment for localized forms of lung cancer non-small cell. It allows a 5-year survival exceeding 50% for complete resection of the tumor. This is a heavy treatment, resulting in a mortality of 4 to 8% and a morbidity of 20-60%. Securing this procedure is a major public health issue. The non-invasive ventilation is a technique commonly used postoperatively in acute respiratory distress and in the treatment of sleep apnea syndromes. Through its effect on oxygenation and pulmonary function parameters, the non-invasive ventilation achieved during 7 days minimum before the intervention could significantly reduce postoperative complications in patients with an obstructive or restrictive disorder, obesity or chronic heart failure.

The aim of the study is to demonstrate that the non-invasive ventilation in two pressure levels achieved during at least 7 days before surgery lung resection (lobectomy or segmentectomy) halved the pulmonary and cardiovascular postoperative patients with obstructive ventilatory disorder or restrictive, obesity or chronic heart failure.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
300
Inclusion Criteria
  • Patient over 18 years, to benefit from surgery scheduled for lung resection (lobectomy or segmentectomy) for primary lung cancer and having signed an informed consent.

AND

  • Trouble obstructive (FEV / FVC <70% and FEV <80% predicted)

Or restrictive (FVC <80% or TLC <80%)

Or decrease in the ratio TLCO / VA <60%

Or history of respiratory failure with hypercapnic Pa CO2> 45 mmHg in the year preceding surgery

Or long-term oxygen

Or heart failure (clinical signs of heart failure and LVEF <55% or disorder of relaxation on echocardiography or atrial fibrillation)

Or history of acute cardiogenic pulmonary edema.

Or obesity (BMI> 30 kg/m2)

Exclusion Criteria
  • Inability to consent

  • Patient declared inoperable given the comorbidities or refusing surgery or with unresectable tumors.

  • Patient operable but with no comorbidities described in the inclusion criteria

  • Contraindications to the non-invasive ventilation:

    • Lack of understanding of the technical
    • facial malformation
    • Tight stenosis of the upper airway
    • uncontrollable vomiting
    • Unable to remove the mask
    • Cognitive impairment or severe psychiatric jeopardizing the observance of the NAV
  • Patient non-insured

  • Patient already on invasive ventilation or non-invasive

  • During Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Reduction of pulmonary complications and cardiovascular postoperative1 month

Demonstrate that the non-invasive ventilation in two pressure levels achieved during at least 7 days before surgery lung resection (lobectomy or segmentectomy) halved the pulmonary and cardiovascular postoperative patients with obstructive ventilatory disorder or restrictive, obesity or chronic heart failure.

Secondary Outcome Measures
NameTimeMethod
Identifying sub-groups of patients1 month

Identify subgroups of patients benefiting most from a non-invasive ventilation preoperatively and safety of this technique preoperatively.

Trial Locations

Locations (15)

Centre Hospitalier du Pays d'Aix

🇫🇷

Aix en Provence, France

CHU Angers

🇫🇷

Angers, France

Centre Hospitalier Victor Dupouy

🇫🇷

Argenteuil, France

Clinqiue du Grand Large

🇫🇷

Brest, France

CHRU de Brest - Hôpital Morvan

🇫🇷

Brest, France

Inter Army Hospital, Clermont-Tonnerre

🇫🇷

Brest, France

Inter Army Hospital

🇫🇷

Clamart, France

CHI Créteil

🇫🇷

Créteil, France

CHU Limoges

🇫🇷

Limoges, France

Hospital, Pasteur

🇫🇷

Nice, France

Scroll for more (5 remaining)
Centre Hospitalier du Pays d'Aix
🇫🇷Aix en Provence, France

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