The Influence of Different Breathing Modes on Oxygenation in a Lung Ventilatio

Not Applicable

Completed

• Conditions: One lung ventilation; Anaesthesiology - Other anaesthesiology

• Registration Number: ACTRN12617000754347
• Lead Sponsor: Cengiz sahutoglu

Brief Summary

inety-eight patients were enrolled in the study, with eighty patients completing it. The mean age of all patients, of whom 70% (n=56) were male, was 56.5±14.9 (range: 20 to 75) years. Of these patients, 87.5% and 12.5% underwent lobectomies due to lung tumors and bronchiectasis, respectively. Of these, 40% had more than one systemic disease, while 32.5% did not have any comorbid conditions. Twenty patients had chronic obstructive pulmonary disease, 20 patients had hypertension, 6 patients had coronary artery disease, 3 patients had cerebrovascular disease, 11 patients had diabetes mellitus, 8 patients had multinodular goitre, and 56 patients were smokers. Evaluation of intra- and postoperative first 24-hour blood gases demonstrated that the PaO2 values were significantly higher with TLV only in the PCV-VG mode. However, remaining values including PH, PaCO2, PaO2, PaO2/FiO2, and lactate were similar. PIP, measured from the intraoperative mechanical ventilator in the VCV group and the dynamic compliance in the PCV-VG group, were found to be significantly higher. Mean airway pressure measured on TLV was found to be high in the PCV-VG group, whereas the remaining mean airway pressure measurements and static compliance were found to be similar. Mean arterial pressure, heart rate, and CVP values of the patients were similar throughout the study period in both group 1 and group 2. Total fluid amount (1000 mL (500-1700) vs 1000 mL (550-2300), P=0.088) and urine output (0.97±0.7 mL/kg/h vs 0.88±0.41 mL/kg/h) were similar in both groups. Half of the patients (18 vs 22) showed an increase in FiO2 due to decreased oxygen saturation below 92% during the intraoperative period, while insufflation was applied to the independent lung of nine patients (group 1:3 vs group 2:6) due to lack of response to this maneuver. Most patients with a significant increase in airway pressure (PP>35 cm H2O) were in the VCV mechanical ventilation mode. Fiberoptic bronchoscopy was used to confirm tube location (group 1, n=1 vs group 2, n=10). Despite several interventions, intermittent two-lung ventilation was performed in eight patients with continuous high levels of desaturation or airway pressure (group 1, n=1 vs group 2, n=7). At least one major complication was reported in 16% of the patients (n=13). Respiratory complications occurring in 12.5% (n=10) of the patients was the most frequent complication. Five of the patients developed a clinical presentation of acute renal failure, while none received dialysis. Only one of the patients (1.3%) died, due to multi-organ failure.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Completion: 2017-03-10
• Study Start: 2017-05-22
• Last Update Posted: 15 July 2019

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

Lung lobectomy patients (Only lung lobectomy under one lung ventilation)

Exclusion Criteria

Patients were excluded if they had renal, cardiac, hepatic impairment; a body mass index greater than 30 kg/m2, and defined as less than 50% of the predicted values of forced expiratory volume in 1 second and forced vital capacity.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
hemodynamic parameters (Mean arterial pressure, heart rate, CVP)[At baseline, and 15 and 60 mins of OLV, at 15 mins of TLV after lobectomy, and postoperative 6th and 24th-hour (invasive arterial pressure, central venous pressure, pulse oximetry, ECG on hemodynamic monitor)];The effect of pressure-controlled ventilation-volume guaranteed on arterial blood gas values<br>[At baseline (post intubation), and 15 and 60 mins of OLV, at 15 mins of TLV after lobectomy, and postoperative 6th and 24th-hour (arterial blood gas analysis will be used)];peak inspiratory pressure (PIP)[At baseline (post intubation), 15th and 60th min OLV, and 15 min after TLV following lobectomy were recorded. <br>(Airway pressure monitoring, Datex-Ohmeda Avance Anesthesia Machine, GE Healthcare, Madison WI USA)]