Impact of Intraoperative Protective One-lung Ventilation in Patients Undergoing Esophagectomy : a Prospective Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Acute Lung Injury
- Sponsor
- Shanghai Zhongshan Hospital
- Enrollment
- 101
- Locations
- 1
- Primary Endpoint
- cytokines of bronchoalveolar lavage
- Status
- Completed
- Last Updated
- 13 years ago
Overview
Brief Summary
The purpose of this trial is to determine whether low tidal volume during intraoperative one-lung ventilation could decrease the incidence rate of postoperative acute lung injury compared to "normal" tidal volume.
Detailed Description
Large tidal volume are known risk factor of acute lung injury.Mechanical ventilation with low tidal volume has been shown to attenuate lung injuries in critically ill patients.Esophagectomy surgery need a relatively long time of one-lung ventilation. A normal tidal volume of two-lung ventilation should be a large one when exerted to one lung. We hypothesized that low tidal volume ventilation during one-lung ventilation could decrease incidence rate of postoperative acute lung injury and mortality.
Investigators
Ming Zhong
department of anesthesiology and surgical intensive care unit
Shanghai Zhongshan Hospital
Eligibility Criteria
Inclusion Criteria
- •clinical diagnosis of esophageal carcinoma and planned for esophagectomy
- •indication for one-lung ventilation
- •informed consent
- •ASA I\~II
Exclusion Criteria
- •NYHA III\~IV
- •severe COPD
- •pulmonary fibrosis
- •any new pulmonary infiltrate on chest radiograph
- •preoperative acute infection suspected
- •altered liver function( Child-Pugh class B or moe)
- •acute or chronic renal failure
- •preoperative corticosteroid treatment during month before inclusion
Outcomes
Primary Outcomes
cytokines of bronchoalveolar lavage
Time Frame: 10 minutes before surgery ,at the end of surgery immediately
TNF-a,IL-1b,IL-6,IL-8 of BAL will be measured with enzyme-linked immunoassay,all markers will be reported with a unit of pg/ml
Secondary Outcomes
- postoperative hospital days(after surgery up to the time when patient is discharged or dead，it is an average)
- incidence rate of acute lung injury(after surgery up to 28 days)
- incidence rate of surgical complications(after surgery up to 28 days)
- inhospital mortality(after surgery up to 28 days)
- Oxygenation Index(10 minutes before surgery,at the end of surgery immediately,12h after surgery)
- CT scan of chest(12 hours after the surgery)