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Nebulized Epoprostenol (FLOLAN) and Phenylephrine on One Lung Ventilation (OLV)

Phase 4
Completed
Conditions
Oxygenation During One Lung Ventilation
Interventions
Registration Number
NCT02748265
Lead Sponsor
University Health Network, Toronto
Brief Summary

This is a pilot study of a new use of Epoprostenol via inhalation (Epoprostenol is approved for intravenous use). The purpose of this study is to administered inhaled Epoprostenol and intravenous Phenylephrine to improve arterial oxygen tension during one-lung anesthesia either with volatile anesthesia (Sevoflurane) or with intravenous anesthesia (Propofol).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
8
Inclusion Criteria
  • Patients undergoing esophagectomy via video assisted thoracoscopy surgery or open thoracotomy.
  • Patients greater than eighteen years old that have the capacity to provide consent.
  • Patients who weigh 89kg or less.
  • Patients with a preoperative platelet count > 100,000mm3
Exclusion Criteria
  • Contraindication or allergy to any of the study drugs e.g. epoprostenol, phenylephrine, sevoflurane or propofol.
  • Spirometry: Force expiratory Volume (FEV1) less than 80% predicted for age. Patients with spirometry indicative of obstructive lung disease are less likely to develop hypoxemia during OLV compared to patients with normal spirometry . These patients are likely to have a smaller treatment effect if any.
  • A history of a bleeding diathesis.
  • Use of a platelet inhibitor within the last seven days e.g. Aspirin, clopidogrel

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Inhaled Epoprostenol, phenylephrine, sevofluraneInhaled Epoprostenol and phenylephrineInhaled Epoprostenol (Flolan), phenylephrine, volatile anesthesia maintenance (Sevoflurane)
Inhaled Epoprostenol phenylephrine & PropofolInhaled Epoprostenol and phenylephrineInhaled Epoprostenol (Flolan), phenylephrine and intravenous anesthesia maintenance (Propofol)
Inhaled Epoprostenol, phenylephrine, sevofluraneSevofluraneInhaled Epoprostenol (Flolan), phenylephrine, volatile anesthesia maintenance (Sevoflurane)
Inhaled Epoprostenol phenylephrine & PropofolPropofolInhaled Epoprostenol (Flolan), phenylephrine and intravenous anesthesia maintenance (Propofol)
Primary Outcome Measures
NameTimeMethod
Increase of arterial oxygen tension in mmHg, during one-lung ventilation surgery, in response to combined nebulized epoprostenol/phenylephrine treatmentChanges measured during surgery, from start of treatment at 30 minutes after one-lung ventilation (T30) to end of the 30 minutes treatment (T60).
Secondary Outcome Measures
NameTimeMethod
Changes in base status in pHChanges measured during surgery, from start of treatment at 30 minutes after one-lung ventilation (T30) to end of the 30 minutes treatment (T60).
Differences between anesthetic technique -volatile vs. intravenous- in increase of arterial oxygen tension in mmHg, during one-lung ventilation surgery, in response to combined nebulized epoprostenol/phenylephrine treatmentChanges measured during surgery, from start of treatment at 30 minutes after one-lung ventilation (T30) to end of the 30 minutes treatment (T60).
Changes in platelet function countChanges measured during surgery, from start of treatment at 30 minutes after one-lung ventilation (T30) to end of the 30 minutes treatment (T60).
Changes in acid status in pHChanges measured during surgery, from start of treatment at 30 minutes after one-lung ventilation (T30) to end of the 30 minutes treatment (T60).
Changes in mean arterial blood pressure in mmHgChanges measured during surgery, from start of treatment at 30 minutes after one-lung ventilation (T30) to end of the 30 minutes treatment (T60).

Trial Locations

Locations (1)

Toronto General Hospital, 200 Elizabeth St.

🇨🇦

Toronto, Ontario, Canada

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