The Use of Constant-flow Technique for Determining the Lower Inflexion Point of Pressure-volume Curve and Intrinsic PEEP During One-lung Ventilation

NCT ID: NCT01532245

Last Updated: 2018-10-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2011-12-31

Study Completion Date

2018-10-23

Brief Summary

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One method for treating intraoperative hypoxia during one-lung ventilation (OLV) is application of PEEP to the dependent lung. However, only a minority of patients benefit from this maneuver. The effect of applied PEEP on oxygenation depends on the relation between the total end-expiratory pressure and the lower inflexion point (LIP) of pressure-volume curve (1). LIP during OLV can be determined with super-syringe technique, but is too complicated for routine operating room use. An alternative is the constant-flow method which is easy and widely used in intensive care settings (2). The investigators goal was to confirm that the constant-flow method as applied by an intensive care ventilator works during OLV.

Methods: After IRB approval and written, informed consent, data were obtained from 20 patients during OLV for thoracic surgery who were ventilated with an AVEA (VIASYS Healthcare) critical-care ventilator. During two-lung ventilation (TLV) and OLV 8 ml•kg-1 tidal volume was used. During OLV, ventilation periods of ten minutes, with and without 5 cmH2O PEEP were alternated. During each period, the investigators recorded arterial blood partial pressures, respiratory and hemodynamic values, intrinsic PEEP (PEEPi), and LIP. PEEPi and LIP were determined using the automatic mode of the ventilator; specifically, LIP was determined with a continuous flow of 3L/minute.

Detailed Description

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Conditions

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One Lung Ventillation (OLV) Two Lung Ventillation (TLV) Positive End Expiratory Pressure (PEEP) Zero End-expiratory Pressure (ZEEP)

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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two-lung ventilation (TLV)

During two-lung ventilation (TLV) and OLV 8 ml•kg-1 tidal volume was used.

Group Type ACTIVE_COMPARATOR

two lung ventilation (TLV)

Intervention Type OTHER

During two-lung ventilation (TLV) and OLV 8 ml•kg-1 tidal volume was used.

one lung ventillation (OLV) without PEEP

During OLV, ventilation periods of ten minutes, with and without 5 cmH2O positive end-expiratory pressure (PEEP) were alternated.

Group Type ACTIVE_COMPARATOR

one lung ventilation (OLV) without PEEP

Intervention Type OTHER

During OLV, ventilation periods of ten minutes, with and without 5 cmH2O positive end-expiratory pressure (PEEP) were alternated.

one lung ventilation (OLV) with PEEP

During OLV, ventilation periods of ten minutes, with and without 5 cmH2Opositive end-expiratory pressure (PEEP) were alternated

Group Type ACTIVE_COMPARATOR

One lung ventilation (OLV) with positive end-expiratory pressure (PEEP)

Intervention Type OTHER

During OLV, ventilation periods of ten minutes, with and without 5 cmH2O positive end-expiratory pressure (PEEP) were alternated

Interventions

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two lung ventilation (TLV)

During two-lung ventilation (TLV) and OLV 8 ml•kg-1 tidal volume was used.

Intervention Type OTHER

one lung ventilation (OLV) without PEEP

During OLV, ventilation periods of ten minutes, with and without 5 cmH2O positive end-expiratory pressure (PEEP) were alternated.

Intervention Type OTHER

One lung ventilation (OLV) with positive end-expiratory pressure (PEEP)

During OLV, ventilation periods of ten minutes, with and without 5 cmH2O positive end-expiratory pressure (PEEP) were alternated

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* thoracic surgery lung ventillation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Cleveland Clinic

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tamás Végh,, M.D.

Role: PRINCIPAL_INVESTIGATOR

Klinikum Ludwigshafen

Other Identifiers

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DEOEC RKEB/IKEB 3504-2011

Identifier Type: -

Identifier Source: org_study_id

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