Effects of Iloprost on Pulmonary Oxygenation in Obese Patients During One-lung Ventilation

Yonsei University78 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, the investigator is planning to investigate the effects of iloprost on respiratory physiology (intrapulmonary shunt, deadspace, oxygenation, etc) in obese patients.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Lung Cancer (Including Metastatic Cancer)Pulmonary Infection

Interventions

When anesthesia induction finishes, change patients' position from supine to lateral position and measure ABGA, VBGA while two lung is ventilated (T0). After 20 minutes of applying one-lung ventilation, measure ABGA and VBGA (T1). Apply normal saline inhalation for control group and measure ABGA at the time of 20 min after normal saline inhalation has finished (T2).

iloprost inhalationDRUG

When anesthesia induction finishes, change patients' position from supine to lateral position and measure ABGA, VBGA while two lung is ventilated (T0). After 20 minutes of applying one-lung ventilation, measure ABGA and VBGA (T1). Apply iloprost inhalation for iloprost group and measure ABGA at the time of 20 min after iloprost inhalation has finished (T2).

Eligibility

Sex: ALLMin age: 40 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. scheduled for VATS lobectomy 2. 40 \< age \< 80 3. American Society of Anaesthesiologists(ASA) physical status classification I\~III 4. BMI \> 30 kg /m2 Exclusion Criteria: 1. American Society of Anaesthesiologists(ASA) physical status classification IV or more 2. NYHA class III\~IV 3. Severe obstructive lung disease and/or restrictive lung disease patients 4. patients with end-organ diseases (i.e. heart failure, respiratory failure, hepatic failure, renal failure) 5. arrhythmia 6. pregnant women 7. pulmonary edema or pulmonary arterial hypertension 8. cerebrovascular disease 9. unstable angina or myocardial infarction within 6 months 10. patients with allergic reaction at iloprost