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To observe the effect of one-lung ventilation (OLV) preconditioning on perioperative oxygenation during thoracic surgery.
For lung isolation and better surgical view, one-lung ventilation(OLV) is essential for thoracic surgery. However, OLV may cause serious pulmonary complications due to intraoperative hypoxia.
Animal studies showed a positive effect of OLV preconditioning (Intermittent OLV before surgical intervention) on perioperative pulmonary oxygenation.
Thus, we designed a study to observe the effect of OLV preconditioning on perioperative oxygenation during thoracic surgery
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| One-lung ventilation | Experimental | Before surgical incision, 2-min of OLV followed by 2-min of TLV (1 cycle) is performed for 5 cycles. |
|
| Two-lung ventilation | No Intervention | Maintain two-lung ventilation until surgical incision |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| One-lung ventilation | Other | The patient undergoing thoracic surgery is intubated with double lumen tube after induction of general anesthesia with propofol and remifentanil. In the intervention group, 5 cycles of one-lung ventilation preconditioning (2-min of one-lung ventilation and 2-min of two-lung ventilation for 1 cycle) is performed before surgical incision. One-lung ventilation is done at dependent lung with FiO2 100% and tidal volume 6 ml kg-1. Two-lung ventilation is done with FiO2 50%, tidal volume 8 ml kg-1. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of hypoxemia | SpO2 < 95% | during one-lung ventilation, up to 5 hours |
| P/F ratio | PaO2/FIO2 ratio | 30min after surgical incision |
| Measure | Description | Time Frame |
|---|---|---|
| Pulmonary complications | Acute lung injury, acute respiratory distress syndrome, atelectasis, pneumonia | 6, 24, 48 hours after surgery, during hospital stay. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jeong-Hwa Seo, PhD | Seoul National University Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | 03080 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 6837992 | Background | Benumof JL. Intermittent hypoxia increases lobar hypoxic pulmonary vasoconstriction. Anesthesiology. 1983 May;58(5):399-404. doi: 10.1097/00000542-198305000-00001. |
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| ID | Term |
|---|---|
| D061810 | One-Lung Ventilation |
| ID | Term |
|---|---|
| D012121 | Respiration, Artificial |
| D058109 | Airway Management |
| D013812 | Therapeutics |
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