Differential Lung Ventilation vs. CPAP

NCT ID: NCT03563612

Last Updated: 2018-06-20

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 29 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-04-01
• Study Completion Date: 2017-09-30

Brief Summary

In this study we compared the efficacy of continuous positive airway pressure (CPAP) to differential lung ventilation, in terms of patient's oxygenation, during video assisted thoracoscopic lung resection.

Detailed Description

Background: One Lung Ventilation (OLV) is the technique used during lung resection surgery in order to facilitate optimal surgical conditions. OLV may result in hypoxemia due to the shunt created. Several techniques are used to overcome the hypoxemia, one of which is continuous positive airway pressure (CPAP) to the non-dependent lung. Another technique is ventilating the non-dependent lung with a minimal volume, thus creating differential lung ventilation (DLV). In this study we compared the efficacy of CPAP to DLV during video assisted thoracoscopic lung resection.

Patients and Method: This is a prospective study of 30 adult patients undergoing elective video assisted thoracoscopic lung lobectomy. Each patient was ventilated in four modes: two lung ventilation, OLV, OLV+CPAP and OLV+DLV. Fifteen patients were ventilated with CPAP first and DLV next, and the other 15 were ventilated with DLV first and then CPAP. Five minutes separated each mode, during which the non-dependent lung was open to room air. We measured the patient's arterial blood gas during each mode of ventilation. The surgeons, who were blinded to the ventilation technique, were asked to assess the surgical conditions at each stage.

Conditions

One Lung Ventilation; Continuous Positive Airway Pressure; Differential Lung Ventilation

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

cpap first, differential ventilation later

Group Type: ACTIVE_COMPARATOR

cpap

Intervention Type: DEVICE

application of cpap to the non-dependent lung, during one lung ventilation

differential ventilation first, cpap late

Group Type: ACTIVE_COMPARATOR

cpap

Intervention Type: DEVICE

application of cpap to the non-dependent lung, during one lung ventilation

Interventions

cpap

application of cpap to the non-dependent lung, during one lung ventilation

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

1. Adult patients diagnised with lung cancer

2. Scheduled to have thoracoscopic lung lobectomy -

Exclusion Criteria

1. Pregnancy

2. ASA>=4

3. Difficult intubation -

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Rambam Health Care Campus

OTHER

Sponsor Role: lead

Responsible Party

Dr Michal Barak

Senior Anesthesiologist

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Rambam Health Care Campus

Haifa, , Israel

Countries

Israel

References

Kremer R, Aboud W, Haberfeld O, Armali M, Barak M. Differential lung ventilation for increased oxygenation during one lung ventilation for video assisted lung surgery. J Cardiothorac Surg. 2019 May 6;14(1):89. doi: 10.1186/s13019-019-0910-2.

Reference Type: DERIVED

PMID: 31060627 (View on PubMed)

Other Identifiers

RMB-0032-16

Identifier Type: -

Identifier Source: org_study_id