Cardiopulmonary Effects of Intrathoracic Pressure Overshoot During Carbon Dioxide Insufflation in Thoracoscopic Surgery

Study Overview
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Brief Summary
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Video-assisted thoracoscopic surgery (VATS) has become a standard technique for addressing all types of thoracic pathology. Insufflation of carbon dioxide (CO2) into the operated chest cavity could increase lung collapse and improve surgical field view. The actual thoracic pressure values may not be identical with the presetting on the insufflator display. This overshoot pressure during VATS may compromise cardiac and pulmonary function. The purpose of this study is to evaluate the effects of intrathoracic pressure overshoot during two-lung ventilation on the hemodynamic and respiratory function and clarify the relative safety of two different techniques of insufflation.

Official Title
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Cardiopulmonary Effects of Intrathoracic Pressure Overshoot During Carbon Dioxide Insufflation in Thoracoscopic Surgery

Conditions
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Esophageal Neoplasms

Intervention / Treatment
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* Device: Insufflation of carbon dioxide (CO2)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists (ASA) Physical Status Ⅰ,Ⅱ Patients with esophageal carcinoma Elective video-assisted thoracic surgery Exclusion Criteria: Allergic to drugs used in the study Refusal of VAST Arrhythmia or treated with antiarrhythmic drug Surgery type were converted to thoracotomy, Massive intraoperative blood loss (> 400ml)

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Flowrate A<br>insufflation of carbon dioxide at 8L/min, 8mmHg | Device: Insufflation of carbon dioxide (CO2)<br>* After patients were positioned, CO2 was insufflated into right pleural cavity at eight or twenty L/min. during video-assisted thoracoscopic surgery, thoracic pressure, hemodynamic and respiratory parameters were recorded.<br>|
| Experimental: Flowrate B<br>insufflation of carbon dioxide at 20 L/min, 8mmHg | Device: Insufflation of carbon dioxide (CO2)<br>* After patients were positioned, CO2 was insufflated into right pleural cavity at eight or twenty L/min. during video-assisted thoracoscopic surgery, thoracic pressure, hemodynamic and respiratory parameters were recorded.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| thoracic pressure overshoot | Time and value of thoracic pressure overshoot during CO2 insufflation | one hour during CO2 insufflation | 
| Hemodynamic change | Hemodynamic changes during each overshoot including Systolic Blood Pressure, Central Venous Pressure and Heart Rate | one hour during CO2 insufflation | 
| Respiratory change | Respiratory changes during each overshoot including Peak Inspiratory Pressure, Pressure flat, Arterial Oxygen Saturation and End-tidal Carbon dioxide | one hour during CO2 insufflation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Circulatory and Respiratory Physiological Phenomena, Thoracoscopy