Effect of PCV and VCV on Extravascular Lung Water

NCT ID: NCT03514706

Last Updated: 2019-03-05

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

COMPLETED

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-03-01

Study Completion Date

2019-03-01

Brief Summary

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Volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) are the common ventilatory modes during OLV undergoing thoracic surgery. A controversy regarding which ventilation mode is better for oxygenation during OLV with PCV enhances oxygenation more than VCV ;given its initial high peak inspiratory flow rates and its rapidly decelerating flow pattern. However, this high peak inspiratory flow rate might also provoke lung injury via shearing and traction forces on the alveoli. Extravascular lung water describes water within the lungs but outside pulmonary vasculature. Lung ultrasound (LUS) assessment of EVLW by B-lines provides a reliable and easy alternative.

Detailed Description

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Conditions

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Extravascular Lung Water

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Adult patients scheduled for elective thoracic surgery with one lung ventilation will be included in the study. Patients will be randomly allocated into one of two groups:

Group V: will receive volume controlled mechanical ventilation. Group P: will receive pressure controlled mechanical ventilation.
Primary Study Purpose

SCREENING

Blinding Strategy

SINGLE

Investigators
Lung ultrasound will be done by an investigator blinded to group allocation

Study Groups

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Volume controlled ventilation

Group V: Patients will receive volume controlled mechanical ventilation. (Vt 7ml/kg ideal body weight).

Group Type EXPERIMENTAL

volume controlled ventilation

Intervention Type DIAGNOSTIC_TEST

Lung ultrasound (LUS) will be performed with a 2-4 MHz phased array probe. Patients will be scanned in supine position by a recording 5 seconds videos. LUS will be assessed for the presence of B lines.

The sum of lung comets produces a score reflecting the extent of lung water accumulation. LUS will be obtained by scanning 12-rib interspaces. The sum of B-lines on each scanning site yields a score from 0 to 36

Pressure controlled ventilation

Group P: Patients will receive pressure controlled mechanical ventilation. (to achieve Vt 7 ml/kg ideal body weight, Pmax 30 cmH2O)

Group Type EXPERIMENTAL

pressure controlled ventilation

Intervention Type DIAGNOSTIC_TEST

Lung ultrasound (LUS) will be performed with a 2-4 MHz phased array probe. Patients will be scanned in supine position by a recording 5 seconds videos. LUS will be assessed for the presence of B lines.

The sum of lung comets produces a score reflecting the extent of lung water accumulation. LUS will be obtained by scanning 12-rib interspaces. The sum of B-lines on each scanning site yields a score from 0 to 36

Interventions

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volume controlled ventilation

Lung ultrasound (LUS) will be performed with a 2-4 MHz phased array probe. Patients will be scanned in supine position by a recording 5 seconds videos. LUS will be assessed for the presence of B lines.

The sum of lung comets produces a score reflecting the extent of lung water accumulation. LUS will be obtained by scanning 12-rib interspaces. The sum of B-lines on each scanning site yields a score from 0 to 36

Intervention Type DIAGNOSTIC_TEST

pressure controlled ventilation

Lung ultrasound (LUS) will be performed with a 2-4 MHz phased array probe. Patients will be scanned in supine position by a recording 5 seconds videos. LUS will be assessed for the presence of B lines.

The sum of lung comets produces a score reflecting the extent of lung water accumulation. LUS will be obtained by scanning 12-rib interspaces. The sum of B-lines on each scanning site yields a score from 0 to 36

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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LUS LUS

Eligibility Criteria

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Inclusion Criteria

* Adult patients aged (18-60 years), undergoing elective thoracoscopic surgery with one lung ventilation

Exclusion Criteria

* Emergency surgeries.
* Left Ventricular ejection fraction less than 40%.
* Any patient known to have pulmonary hypertension
* Patients with preoperative congestive heart failure, cardiogenic shock, preoperative pulmonary edema
* Hepatic patients (liver functions double the upper reference range)
* Morbid obesity (BMI \> 40).
* Renally impaired patients with creatinine more than 2 mg/dl.
* Any patient with respiratory dysfunction (FEV1\<60% of the expected).
* Any patient with previous thoracic surgery.
* One lung ventilation more than 2 hours
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cairo University

OTHER

Sponsor Role lead

Responsible Party

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Hisham Hosny

Associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hisham Hosny, MD

Role: PRINCIPAL_INVESTIGATOR

Kasr Al-Ainy Faculty of Medicine

Locations

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Kasr Al-Ainy faculty of medicine. Cairo University

Cairo, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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AnesthN-8-2018

Identifier Type: -

Identifier Source: org_study_id

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