Effect of PCV and VCV on Extravascular Lung Water

Not Applicable

Completed

• Conditions: Extravascular Lung Water
• Interventions: Diagnostic Test: volume controlled ventilation; Diagnostic Test: pressure controlled ventilation

• Registration Number: NCT03514706
• Lead Sponsor: Cairo University

Brief Summary

Volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) are the common ventilatory modes during OLV undergoing thoracic surgery. A controversy regarding which ventilation mode is better for oxygenation during OLV with PCV enhances oxygenation more than VCV ;given its initial high peak inspiratory flow rates and its rapidly decelerating flow pattern. However, this high peak inspiratory flow rate might also provoke lung injury via shearing and traction forces on the alveoli. Extravascular lung water describes water within the lungs but outside pulmonary vasculature. Lung ultrasound (LUS) assessment of EVLW by B-lines provides a reliable and easy alternative.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-03-01
• Study First Submitted: 2018-04-02
• Study First Submitted QC: 2018-04-30
• Study First Posted: 2018-05-02
• Primary Completion: 2019-01-01
• Status Verified: 2019-03
• Study Completion: 2019-03-01
• Last Update Submitted: 2019-03-04
• Last Update Posted: 2019-03-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• Adult patients aged (18-60 years), undergoing elective thoracoscopic surgery with one lung ventilation

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Exclusion Criteria

• Emergency surgeries.
• Left Ventricular ejection fraction less than 40%.
• Any patient known to have pulmonary hypertension
• Patients with preoperative congestive heart failure, cardiogenic shock, preoperative pulmonary edema
• Hepatic patients (liver functions double the upper reference range)
• Morbid obesity (BMI > 40).
• Renally impaired patients with creatinine more than 2 mg/dl.
• Any patient with respiratory dysfunction (FEV1<60% of the expected).
• Any patient with previous thoracic surgery.
• One lung ventilation more than 2 hours

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Volume controlled ventilation	volume controlled ventilation	Group V: Patients will receive volume controlled mechanical ventilation. (Vt 7ml/kg ideal body weight).
Pressure controlled ventilation	pressure controlled ventilation	Group P: Patients will receive pressure controlled mechanical ventilation. (to achieve Vt 7 ml/kg ideal body weight, Pmax 30 cmH2O)

Primary Outcome Measures

Name	Time	Method
Lung ultrasound score	change of lung ultrasound scores introperatively during double lung and single lung ventilation and after 2 hours postoperatively compared to baseline scores before anesthesia induction	The sum of B lines reflects the extent of lung water accumulation. The lung ultrasound score(LUS) will be obtained by scanning 12-rib interspaces. The dependent lung will be divided into six areas: two anterior areas, two lateral areas, and two posterior areas. The anterior chest wall (zone 1) will be delineated from the parasternal to the anterior axillary line and will be divided into upper and lower halves, from the clavicle to the third intercostal space and from the third to the diaphragm. The lateral area (zone 2) will be delineated from the anterior to the posterior axillary line and was divided into upper and basal halves. The posterior area (zone 3) will be considered as the zone beyond the posterior axillary line. The sum of B-lines on each scanning site (0: absence; 1: B7 lines: multiple B-lines 7 mm apart; 2: B3 lines: multiple B 3 mm apart; 3: consolidation) yields a score from 0 to 36(10) score for the ventilated lung is only from 0-18.

Trial Locations

Locations (1)

Kasr Al-Ainy faculty of medicine. Cairo University; 🇪🇬 Cairo, Egypt