Nebulized Epoprostenol (FLOLAN) and Phenylephrine on One Lung Ventilation (OLV)

University Health Network, Toronto8 enrolled

Overview

This is a pilot study of a new use of Epoprostenol via inhalation (Epoprostenol is approved for intravenous use). The purpose of this study is to administered inhaled Epoprostenol and intravenous Phenylephrine to improve arterial oxygen tension during one-lung anesthesia either with volatile anesthesia (Sevoflurane) or with intravenous anesthesia (Propofol).

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Oxygenation During One Lung Ventilation

Interventions

Inhaled Epoprostenol and phenylephrineDRUG

After 30 minutes of one-lung ventilation, Epoprostenol 50 ng/kg/min is administered via nebuliser in the anesthesia circuit with phenylephrine administered intravenously

SevofluraneDRUG

Volatile maintenance anesthesia

PropofolDRUG

Intravenous maintenance anesthesia

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients undergoing esophagectomy via video assisted thoracoscopy surgery or open thoracotomy. * Patients greater than eighteen years old that have the capacity to provide consent. * Patients who weigh 89kg or less. * Patients with a preoperative platelet count \> 100,000mm3 Exclusion Criteria: * Contraindication or allergy to any of the study drugs e.g. epoprostenol, phenylephrine, sevoflurane or propofol. * Spirometry: Force expiratory Volume (FEV1) less than 80% predicted for age. Patients with spirometry indicative of obstructive lung disease are less likely to develop hypoxemia during OLV compared to patients with normal spirometry . These patients are likely to have a smaller treatment effect if any. * A history of a bleeding diathesis. * Use of a platelet inhibitor within the last seven days e.g. Aspirin, clopidogrel

Locations (1)

Toronto General Hospital, 200 Elizabeth St.

Toronto, Ontario, Canada

Outcomes

Primary Outcomes

Increase of arterial oxygen tension in mmHg, during one-lung ventilation surgery, in response to combined nebulized epoprostenol/phenylephrine treatment