Effectiveness of Lung Sono in One-lung Ventilation

Seoul National University Hospital166 enrolled

Overview

To observe the effectiveness of ultrasound-guided alveolar recruitment in thoracic surgery with one-lung ventilation(OLV).

One-lung ventilation(OLV) is essential in thoracic surgery for patient safety and better surgical view. However, pulmonary complications such as hypoxemia may be caused by OLV which might be preventable with adequate alveolar recruitment and positive end-expiratory pressure(PEEP). Alveolar recruitment has been performed with conventional methods without diagnostic tools in clinical setting. Ultrasound is a non-invasive, radiation-free device with high accuracy for the diagnosis of lung atelectasis. There are a few reports regarding the usefulness of lung ultrasound in other surgeries, but not in thoracic surgeries with OLV. Thus, investigators designed a study to observe the effectiveness of ultrasound-guided alveolar recruitment in thoracic surgery with OLV.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Enrollment

166

Conditions

One Lung Ventilation

Interventions

Lung-sono guidedPROCEDURE

The patient undergoing thoracic surgery is intubated with double lumen tube after induction of general anesthesia with propofol and remifentanil. In the intervention group, alveolar recruitment is performed to the non-surgical side of lung under examination with ultrasound just after anesthesia induction. During the gradual increment in the pressure of recruitment, the anesthesiologist can find the opening pressure that means the minimal pressure at which observed atelectasis starts to disappear. Then, alveolar recruitment is performed with the opening pressure until the atelectasis is not visible.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Elective thoracic surgery which requires one-lung ventilation with lateral decubitus position Exclusion Criteria: * Patients who refuse to agree * Previous lung surgical history * History of pneumothorax or bullae * Severe cardiopulmonary disease, COPD * Operation time \< 1hr

Locations (1)

Seoul National University Hospital

Seoul, South Korea

Outcomes

Primary Outcomes

Incidence of desaturation

SpO2\<95%

Time frame: intraoperative

P/F ratio

PaO2/FiO2 ratio

Time frame: 30 minutes after one-lung ventilation

Secondary Outcomes

Lung ultrasound score

Lung ultrasound score of atelectasis

Time frame: just after anesthesia induction, end of surgery

Alveolar dead space

(PaCO2-PetCO2)xVt/PaCO2

Time frame: 30 minutes after one-lung ventilation

Pulmonary complications

respiratory infection, respiratory failure, pleural effusion, atelectasis, pneumothorax, atelectasis, bronchospasm, aspiration pneumonitis

Time frame: intraoperative, during hospital stay(an average of 3 days)

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.