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Patients scheduled for lung lobe resection using video assisted thoracic surgery will be randomly assigned to be ventilated with either only oxygen or a mixture of air and oxygen.
The primary purpose of this study is to determine if the incidence of postoperative collapse (in the non-surgical lung) is decreased when using a mixture of air and oxygen compared to using only oxygen (which is our control measurement) during one-lung ventilation.
One of the concerns with all thoracic procedures employing One Lung Ventilation (OLV) is intra-operative hypoxia due to the large shunt that develops when only one lung is being ventilated. Ventilation with a higher fraction of inspired oxygen (FIO2) is one of the commonly chosen strategies for the treatment of hypoxemia during (OLV) for thoracic surgery. Using an FIO2 of 1.0 at all times during (OLV), however, may increase the risk of absorption atelectasis intra and postoperatively which itself leads to persistent hypoxia and potentially pneumonia.
The aim of this study is therefore to determine the impact of adding air to the inspired fraction of oxygen during (OLV) primarily on the incidence of postoperative atelectasis of the nonsurgical lung after lung resection using video assisted thoracic surgery and secondarily on intraoperative and postoperative oxygenation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Air/Oxygen Mixture | Experimental | Patients in this group will be ventilated with a mixture of air and oxygen during one lung ventilation. |
|
| Oxygen | Active Comparator | Patients in this group will be ventilated with only oxygen during one lung ventilation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| One Lung Ventilation | Other | Patients in this group will be ventilated with a mixture of air and oxygen during one lung ventilation. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of postoperative atelectasis | The primary objective is to determine if the incidence of postoperative atelectasis is decreased in the non-surgical lung, during one-lung ventilation (OLV) with mixture of air and oxygen compared to (OLV) using only oxygen (which is our control measurement) . | Immediately after the surgery - up to 2 days post operative. |
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of intraoperative and postoperative hypoxia (SpO2 < 90%) . | Intra-operative and Post operative day 1 and 2 . |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Neal Badner, MD, FRCP(C) | Contact | +1 (519) 685-8500 | 55115 | Neal.Badner@lhsc.on.ca |
| Hesham Youssef, M.B.,B.Ch | Contact | +1 (519) 685-8500 | 17820 | heshanm.youssef@lhsc.on.ca |
| Name | Affiliation | Role |
|---|---|---|
| Neal Badner, MD, FRCP(C) | London Health Science Centre, University Of Western Ontario | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Victoria Hospital | Recruiting | London | Ontario | N6A 5W9 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 7717553 | Background | Rothen HU, Sporre B, Engberg G, Wegenius G, Hogman M, Hedenstierna G. Influence of gas composition on recurrence of atelectasis after a reexpansion maneuver during general anesthesia. Anesthesiology. 1995 Apr;82(4):832-42. doi: 10.1097/00000542-199504000-00004. | |
| 11273912 | Background | Schwarzkopf K, Klein U, Schreiber T, Preussetaler NP, Bloos F, Helfritsch H, Sauer F, Karzai W. Oxygenation during one-lung ventilation: the effects of inhaled nitric oxide and increasing levels of inspired fraction of oxygen. Anesth Analg. 2001 Apr;92(4):842-7. doi: 10.1097/00000539-200104000-00009. |
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| ID | Term |
|---|---|
| D001261 | Pulmonary Atelectasis |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D061810 | One-Lung Ventilation |
| ID | Term |
|---|---|
| D012121 | Respiration, Artificial |
| D058109 | Airway Management |
| D013812 | Therapeutics |
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| One Lung Ventilation | Other | Patients in this group will be ventilated with only oxygen during one lung ventilation. |
|
|
| 7760608 | Background | Rothen HU, Sporre B, Engberg G, Wegenius G, Reber A, Hedenstierna G. Prevention of atelectasis during general anaesthesia. Lancet. 1995 Jun 3;345(8962):1387-91. doi: 10.1016/s0140-6736(95)92595-3. |