Clinical trial NCT03296449: Comparison Between CPAP and HFJV During One-lung Ventilation in VATS
Official title: Comparison Between Continuous Positive Airway Pressure and High-frequency Jet Ventilation in Nondependent Lung During One-lung Ventilation in Video-assisted Thoracoscopic Surgery
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: One-Lung Ventilation
Thoracic Surgery, Video-Assisted
Keywords: Hypoxia
High-Frequency Jet Ventilation
Continuous Positive Airway Pressure
Lead sponsor: Hospital General Universitario de Alicante
Sponsor class: OTHER
First posted: 2017-09-28
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: SUPPORTIVE_CARE

Brief summary: This study compares two ventilatory techniques (continuous positive airway pressure vs high frequency jet ventilation) during one-lung ventilation (OLV) in video-assisted thoracic surgery (VATS). All patients were ventilated with both ventilatory techniques and parameters of gas exchange were determined through arterial blood gas test.

Detailed description: One-lung ventilation is mandatory during most thoracic surgery procedures. During OLV, collapsed lung develops an intrapulmonary shunt leading to arterial hypoxemia. Since arterial hypoxemia is a critical intraoperative problem, many times , anesthesiologists have to use rescue ventilation strategies on non-dependent lung to improve arterial oxygen levels. The use of continuous positive airway pressure on non-dependent lung has become the most common technique to achieve that aim.

High-frequency jet ventilation on non-dependent lung may be considered as an alternative way of ventilation of the non-dependent lung during one-lung ventilation because it provides a suitable gaseous exchange while facilitating minimizing surgical field motion. However, this ventilation maneuver is rarely use by thoracic anesthesiologists.

Over the last years, video assisted thoracic surgery (VATS) has become widely utilized. This surgical technique becomes even more dependent on immobilization of the operation field than open-chest thoracic procedures. There is a lack of evidence in the current literature regarding the use of HFJV in VATS.

The purpose of this study is to evaluate the effects of HFJV as an alternative for the treatment of hypoxemia in VATS.

One-lung ventilation is mandatory during most thoracic surgery procedures. During OLV, collapsed lung develops an intrapulmonary shunt leading to arterial hypoxemia. Since arterial hypoxemia is a critical intraoperative problem, many times , anesthesiologists have to use rescue ventilation strategies on non-dependent lung to improve arterial oxygen levels. The use of continuous positive airway pressure on non-dependent lung has become the most common technique to achieve that aim.

High-frequency jet ventilation on non-dependent lung may be considered as an alternative way of ventilation of the non-dependent lung during one-lung ventilation because provide suitable gaseous exchange while facilitate minimizing surgical field motion. However , this ventilation maneuver is rarely use by thoracic anesthesiologists.

Over the last years, video assisted thoracic surgery (VATS) has become widely utilized. This surgical technique becomes even more dependent on immobilization of the operation field than open-chest thoracic procedures. There is a lack of evidence in the current literature about the use of HFJV in VATS.

The purpose of this study is to evaluate the effects of HFJV as an alternative for the treatment of hypoxemia in VATS.

Eligibility criteria: Inclusion Criteria:

* Subject requiring one-lung ventilation
* Subject under video-assisted thoracic surgery

Exclusion Criteria:

* Pregnant
* Emergent surgery
* Hemodynamic instability

Primary outcomes:
measure: PaO2/FiO2
timeFrame: 1 day
Secondary outcomes:
measure: PaCO2
timeFrame: 1 day
measure: Operative field conditions
timeFrame: 1 day
Other outcomes:
measure: Airway pressures
timeFrame: 1 day
measure: Adverse effects and complication
timeFrame: 30 days
measure: Hemodynamic parameters
timeFrame: 1 day
Locations:
city: Alicante
country: Spain
facility: Hospital General Universitario de Alicante
Study officials:
affiliation: Hospital General Universitario de Alicante
name: Maria Galiana
role: PRINCIPAL_INVESTIGATOR
References: