Effect of Iloprost on Pulmonary Oxygenation in Patients With Low Diffusing Capacity During One-lung Ventilation

Yonsei University40 enrolled

Overview

One lung ventilation (OLV) is essential during thoracic surgery. During OLV, intrapulmonary shunt can be increased resulting hypoxemia. Although OLV technique had been advanced so far, hypoxemia during OLV reaches about 10% in spite of inspired oxygen fraction 100%. Iloprost is a prostaglandin analogue used for pulmonary hypertension, which can decrease pulmonary artery resistance by selectively dilating pulmonary artery. In this prospective, randomized, double blind study, investigators are planning to investigate the effects of iloprost on respiratory physiology (intrapulmonary shunt, deadspace, oxygenation, etc).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Lung Cancer

Interventions

iloprost

20μg(2ml) of inhaled iloprost (Ventavis®) When anesthesia induction finishes, change patients' position from supine to lateral position and measure arterial blood gas analysis (ABGA), venous blood gas analysis (VBGA) while two lung is ventilated. After 20 minutes of applying one lung ventilation, measure ABGA. Apply iloprost or normal saline inhalation for each iloprost and control group and measure ABGA at the time of 20 min and 40 min after iloprost (or normal saline) inhalation has finished.

normal salineDRUG

20μg(2ml) of inhaled normal saline When anesthesia induction finishes, change patients' position from supine to lateral position and measure ABGA, VBGA while two lung is ventilated. After 20 minutes of applying one lung ventilation, measure ABGA. Apply iloprost or normal saline inhalation for each iloprost and control group and measure ABGA at the time of 20 min and 40 min after iloprost (or normal saline) inhalation has finished.

Eligibility

Sex: ALLMin age: 40 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * scheduled for Video-assisted thoracoscopic surgery (VATS) lobectomy * 40 \< age \< 80 * American Society of Anaesthesiologists (ASA) physical status classification I\~III * diffusing capacity (DLCO) \<75% at pre op. pulmonary function test Exclusion Criteria: * American Society of Anaesthesiologists (ASA) physical status classification IV * New York Heart Association (NYHA) class III\~IV * Severe obstructive lung disease and/or restrictive lung disease patients * patients with end-organ diseases (i.e. heart failure, respiratory failure, hepatic failure, renal failure) * arrhythmia * pregnant women * disease that can influence the DLCO result (anemia, pulmonary vascular disease)

Outcomes

Primary Outcomes

PaO2(partial pressure of arterial oxygen) ratio

Time frame: 40 minutes after iloprost inhalation

incidence of intrapulmonary shunt