Echocardiographic Evaluation of the Change on Pulmonary Blood Flow and Cardiac Function Induced by Capnothorax During One Lung Ventilation

N/ACompletedNCT02220231

Yonsei University25 enrolled

Overview

Video-assisted thoracoscopic extended thymectomy (VATET) is a minimally-invasive method for excision of mediastinal mass instead of open thymectomy. The iatrogenic capnothorax with one-lung ventilation during VATET may cause hemodynamic instability due to the compression of intrathoracic structures. The purpose of this study is to evaluate the effects of capnothorax on the pulmonary blood flow and cardiac function during the VATET by using the transesophageal echocardiography.

Study Type

INTERVENTIONAL

Allocation

Masking

NONE

Enrollment

Conditions

Mediastinal Tumors

Interventions

capnothoraxPROCEDURE

After patient positioning, the capnothorax will be created by insufflation of carbon dioxide in patients undergoing video-assisted thoracoscopic extended thymectomy.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Above 20 years of age. 2. American Society of Anesthesiologists (ASA) Physical Status I, II, III. 3. Thoracic surgical procedure (video-assisted thoracoscopic extended thymectomy ) Exclusion Criteria: 1. Severe functional liver or kidney disease 2. Diagnosed HF ( NYHA class \>3) 3. Arrhythmia or received treatment with antiarrhythmic drug . 4. Exceed BMI \> 30 kg/ m2 5. COPD 6. Pathologic esophageal lesion (esophageal stricture or varix ) 7. Pregnancy

Outcomes

Primary Outcomes

The changes of the echocardiographic indices

pulmonary blood flow = PVA(cross sectional area of LUPV) x VTI(velocity time integral) x HR , Fractional area change = \[(LVAd-LVAs)/LVAd\] × 100 Ejection fraction = \[(LVEDV(LV end-diastolic volume) -LVESV(LV end-systolic volume)/LVEDV\] × 100

Time frame: four time points during the operation. (1)10 min after induction (baseline); (2) 1 min after CO2 insufflation; (3)10 min after of CO2 insufflation; and (4)20 min after CO2 insufflation

Secondary Outcomes

The changes of the oxygenation and respiratory dynamic parameters

shunt fraction Qs/Qt = (CcO2- CaO2)/(CcO2- CvO2) CcO2 = Hgb x 1.34 x ScO2 + PcO2 x 0.003, lung compliance : Compliance= Vt / Pplat, physiologic dead space : Vd/Vt = 1.14 x (PaCO2 - PETCO2)/PaCO2- 0.005

Time frame: four time points during the operation, an expected average of 3 hours. (1)10 min after induction (baseline); (2) 1 min after CO2 insufflation; (3)10 min after of CO2 insufflation; and (4)20 min after CO2 insufflation

Data from ClinicalTrials.gov

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