Comparative Analysis of the Lung Inflammatory Response After Thoracic Surgery With Single or Double Lung Ventilation: a Randomized, Pilot, Trial

Universidade do Extremo Sul Catarinense - Unidade Academica de Ciecias da Saude40 enrolled

Overview

The goal of this clinical trial is to compare in patients undergoing thoracic procedures the lung inflammatory response in on one-lung ventilation and two-lung ventilation strategies The main question to answer is: • Lung inflammation differs when comparing one to two-lung ventilation strategies during the procedure? Participants will be divided in the classic one lung ventilation or two lung ventilation (using pneumothorax with CO2) and different biomarkers of lung inflammation will be measured after procedures.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Thoracic Diseases Surgery

Interventions

The intervention do not involve a drug or device. It will be compared two different approaches to ventilate the lungs during the procedure . In this arm both lungs will be ventilated inserting a disposable trocar into the pleural cavity, and insufflating CO2 into the thoracic cavity via an insufflator. The insufflation pressure and the flow rate will be set as 8 mmHg and 10 l.min-1, of the cavity with CO2. The insufflator will be adjusted for cavity pressure in 8mmHg and flow of 10L/min.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * A diagnosis of pleural or mediastinal pathology that requires diagnostic or therapeutic surgical intervention; * Written consent to participate Exclusion Criteria: * Pregnant women; * Patients on mechanical ventilation prior to the procedure; * Patients classified by the American Society of Anesthesiology (ASA) as class 4; * Patients with subpulmonary or diaphragmatic pathologies, where it is believed that the two pulmonary technique is superior; * Impossibility of using a double-lumen tube or difficult intubation; * Patient does not support one-lung ventilation; * Patient with previous lung resection surgery

Outcomes

Primary Outcomes

Bronchoalveolar lavage fluid (BALF) levels of IL-6

It will be compared the levels of IL-6 in the BALF collected immediately before and after the thoracic procedure