Effects of Different Levels of Physical Activity on Postoperative Pulmonary Complications in Patients Undergoing Thoracoscopic Lung Resection Surgery Under General Anesthesia

Study Overview
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Brief Summary
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Due to the special operation location and the obvious characteristics of ventilator-related lung injury during anesthesia in lung resection surgery, the incidence of postoperative pulmonary complications is higher than that of other surgeries, and it is one of the important factors affecting the postoperative outcomes of patients. Previous studies have shown that reaching a certain level of activity or continuing regular exercise can reduce or prevent postoperative pulmonary complications without taking drugs. Therefore, the researchers designed this study to explore the influence of different levels of physical activity on postoperative lung complications after thoracoscopic lung resection surgery under general anesthesia, which has important clinical guiding significance for preoperative comprehensive assessment of patients' lung function, screening of fragile lungs and intraoperative lung protective ventilation strategy.

Official Title
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Effects of Different Levels of Physical Activity on Postoperative Pulmonary Complications in Patients Undergoing Thoracoscopic Lung Resection Surgery Under General Anesthesia: a Prospective Cohort Study

Conditions
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Postoperative Pulmonary Complications

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients older than 18 years and younger than 80 years; Patients scheduled to accept elective thoracic surgery under general anesthesia; Patients of American Society of Anesthesiologists (ASA) Ⅱ～Ⅲ level grade; Patients signed the informed consent form for the clinical study. Exclusion Criteria: Patients with moderate or severe chronic obstructive pulmonary disease (GOLD Grade III or IV level grade)； Patients with severe or uncontrolled bronchial asthma； Patients with severe neuromuscular disease or thoracic malformation； Patients with severe heart disease (New York Heart Association Class III or IV level grade or acute coronary syndrome or persistent ventricular arrhythmia)； Patients with cognitive dysfunction； Patients who have participated in other clinical trials within the previous 30 days； Patients with coagulation dysfunction； Patients who received radiotherapy or chemotherapy within 2 months before surgery.

Ages Eligible for Study
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Minimum Age: 18 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Adequate physical activity group<br>At least 600 met-minutes /week for five or more days of walking, moderate and strenuous physical activity per week. | |
| Insufficient physical activity group<br>Less than 600 met-minutes /week for five or more days of walking, moderate and strenuous physical activity per week. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of pulmonary complications | Atelectasis Respiratory failure Pleural effusion Pneumonia Unplanned non-invasive or invasive ventilation Pulmonary congestion bronchospasm pneumothorax | Within five days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The arterial levels of inflammatory markers | interleukin-6(IL-6), interleukin-8(IL-8), tumor necrosis factor-α(TNF-α) | before induction of anesthesia(T0),1.5 hours after the beginning of surgery(T2),3 hours after the beginning of surgery(T3)and 1 hour after the end of surgery(T4). | 
| The number of postoperative pulmonary complications |  | Within five days after the surgery | 
| Incidence of pulmonary complications | Atelectasis Respiratory failure Pleural effusion Pneumonia Unplanned non-invasive or invasive ventilation Pulmonary congestion bronchospasm pneumothorax | One month after the surgery | 
| Extubation time |  | The time from the end of surgery to the removal of the endotracheal intubation. | 
| Postoperative length of stay |  | During the study procedure | 
| Incidence of postoperative adverse events | arrhythmia acute cardiovascular disease (myocardial infarction, heart failure) acute cerebrovascular disease (cerebral infarction, cerebral hemorrhage) acute postoperative psychiatric disorder (delirium,somnolence,coma) shock | Within five days after operation | 
| Unplanned admission to the ICU |  | Within 1 month after operation | 
| Mortality 1 month after surgery |  | Within 1 month of the end of surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postoperative pulmonary complications, lung resection surgery, Physical activity, General anesthesia