Clinical trial NCT02583984: Metabolomic Study in Exhaled Breath Condensate of Thoracic Surgical Patients
Official title: Metabolomic Study in Exhaled Breath Condensate of Thoracic Surgical Patients
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Acute Pulmonary Insufficiency Following Thoracic Surgery
Ventilator-associated Lung Injury
Lead sponsor: National Taiwan University Hospital
Sponsor class: OTHER
First posted: 2015-10-22
Enrollment: 40
Sex: ALL
Minimum age (years): 20
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Thoracic surgical patients requiring lung isolation

Brief summary: Acute lung injury (ALI) following thoracic surgery remains a major source of morbidity and mortality after lung resection. One-lung ventilation (OLV) is usually required in thoracic surgery. OLV is also an important predictor of postoperative ALI. Recent laboratory findings suggested that tissue hypoxemia and ischemia / reperfusion injury of the collapsed lungs during OLV is the major cause of lung injury. Exhaled Breath Condensate (EBC), which is the exhalate from breath typically collected by cooling device, contains most molecules found in the airway. Metabolomics refers to systematic and scientific study of chemical processes involving metabolites. This study will collect EBC for metabolomic analysis and aim to elucidate the biochemical reactions during one-lung ventilation and pathological mechanisms of acute lung injury following thoracic surgery.

Detailed description: Acute lung injury (ALI) following thoracic surgery remains a major source of morbidity and mortality after lung resection. Despite the advancement in both the surgical techniques and the perioperative management, the incidence of postoperative ALI remains remarkable. Risk factors for postoperative lung injury are evident, including preoperative pulmonary function, type of surgical procedure, intraoperative fluid management, one-lung ventilation, and ventilator settings. One-lung ventilation (OLV) is usually required in thoracic surgery. OLV is also an important predictor of postoperative ALI. Recent laboratory findings suggested that tissue hypoxemia and ischemia / reperfusion injury of the collapsed lungs during OLV is the major cause of lung injury. Exhaled Breath Condensate (EBC), which is the exhalate from breath typically collected by cooling device, contains most molecules found in the airway. EBC analysis has potential applications in lung disease, such as severity of airway inflammation in asthmatic patients. Collecting EBC is simple and non-invasive, in contrast to bronchoscopy for lung biopsy or bronchoalveolar lavage. Metabolomics refers to systematic and scientific study of chemical processes involving metabolites. This study will collect EBC from thoracic surgical patients before, during, and after OLV. The investigators will perform metabolomic analysis and aim to elucidate the biochemical reactions during one-lung ventilation and pathological mechanisms of acute lung injury following thoracic surgery.

Eligibility criteria: Inclusion Criteria:

* Thoracic surgical patients requiring lung isolation
* Pulmonary resection: lobectomy, segmentectomy
* Esophageal surgery and no pulmonary resection
* Mediastinal surgery and no pulmonary resection

Exclusion Criteria:

* Metabolic disorder
* Metabolic syndrome
* Diabetes
* Pregnancy

Primary outcomes:
measure: Number of participants with acute lung injury following thoracic surgery
timeFrame: 30 days
Secondary outcomes:
measure: Metabolome of exhaled breath condensate associated with lung injury in thoracic surgery
timeFrame: 5 hours
Other outcomes:
Locations:
city: Taipei City
country: Taiwan
facility: Department of Anesthesiology, National Taiwan University Hospital
Study officials:
affiliation: National Taiwan University Hospital
name: Ya-Jung Cheng, MD, PhD
role: STUDY_CHAIR
References: