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This study will be conducted in the Affiliated Hospital of Nantong University. Sixty colorectal cancer(CRC) patients are randomized into traditional ventilation strategy group (control group) and lung protective ventilation strategy group (experimental group), there were 30 cases in each group. The control group adopted conventional ventilation strategy; the experimental group used lung protective ventilation strategy. 4ml of central venous blood was extracted at 3 time points within 24h, and relevant experimental indexes were determined. Observe the effect of lung protective ventilation strategy on the microenvironment of tumor inflammation and related hematological indexes in patients undergoing colorectal cancer surgery. Follow-up frailty score and quality of recovery score at 1,3,6, and 12 months after surgery (QoR-15 score scale).
This study will be conducted in the Affiliated Hospital of Nantong University. Sixty CRC patients are randomized into traditional ventilation strategy group (control group) and lung protective ventilation strategy group (experimental group), there were 30 cases in each group. The control group adopted conventional ventilation strategies: tidal volume (VT)=10-12 ml/kg, respiratory rate ( f)=12 breaths / minute, positive end expiratory pressure(PEEP)=0 cmH₂O, fraction of inspired oxygen =0.5; the experimental group used lung protective ventilation strategies: tidal volume ( VT)=6-8 ml/kg, f=12 breaths / minute, positive end expiratory pressure (PEEP)=6-8 cmH₂O, fraction of inspired oxygen =0.5, mechanical ventilation every 30 minutes (continuous positive airway pressure 30 cmH₂O about 30 seconds). 4 ml of central venous blood was extracted at 3 time points within 24h, and relevant experimental indexes were determined. Observe the effect of lung protective ventilation strategy on the microenvironment of tumor inflammation and related hematological indexes NLDA, PDM, SII and PNI in patients undergoing colorectal cancer surgery. Follow-up frailty score and quality of recovery score at 1,3,6, and 12 months after surgery (QoR-15 score scale).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| conventional ventilation strategy group | Other | The conventional ventilation strategy group used a conventional ventilation strategies: tidal volume(VT)=10-12 ml/kg, respiratory rate(f)=12 beats/minute, end-expiratory positive pressure(PEEP)= 0 cm H₂O, fraction of inspired oxygen = 0.5 |
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| lung protective ventilation strategy group | Experimental | The lung protective ventilation strategy group used the lung protective ventilation strategies : tidal volume(VT)=6-8 ml/kg, f=12 breaths / minute,end-expiratory positive pressure(PEEP) = 6-8 cmH₂O, and fraction of inspired oxygen = 0.5 . After mechanical ventilation every 30 minutes (continuous positive airway pressure 30 cmH₂O for 30 seconds). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lung protective ventilation strategy | Procedure | They were divided into 2 groups: traditional ventilation strategy group (control group) and lung protective ventilation strategy group (experimental group), with 30 cases in each group. In the conventional ventilation strategy group, the conventional ventilation strategies were followed: tidal volume (VT)=10-12ml/kg, respiratory rate(f) =12 times/minute, PEEP=0 cmH₂O, fraction of inspired oxygen=0.5; Lung protective ventilation strategies were implemented in the Lung protective ventilation strategy group: VT=6-8ml/kg, f=12 times/min, PEEP=6-8 cm H₂O,fraction of inspired oxygen=0.5 Manual lung reexpansion was performed every 30 minutes after mechanical ventilation (continuous positive airway pressure of 30 cm H₂O for 30 seconds). |
| Measure | Description | Time Frame |
|---|---|---|
| Microenvironment-related indicators of tumor inflammation | Concentrations of tumor necrosis factor alpha (TNF-α) | 10 minutes before anesthesia, 1 hour and 24 hours after the procedure |
| Microenvironment-related indicators of tumor inflammation | Concentrations of nucleartranscriptionfactorkappaB (NF-kB) | 10 minutes before anesthesia, 1 hour and 24 hours after the procedure |
| Microenvironment-related indicators of tumor inflammation | Concentrations of interleukin-6 (IL-6) | 10 minutes before anesthesia, 1 hour and 24 hours after the procedure |
| Microenvironment-related indicators of tumor inflammation | Concentrations of Tumor-associated macrophages (TAMs) | 10 minutes before anesthesia, 1 hour and 24 hours after the procedure |
| Microenvironment-related indicators of tumor inflammation | Concentrations of vascular endothelial growth factor (VEGF) | 10 minutes before anesthesia, 1 hour and 24 hours after the procedure |
| Microenvironment-related indicators of tumor inflammation | Concentrations of Janus Kinase 1 (JAK1) | 10 minutes before anesthesia, 1 hour and 24 hours after the procedure |
| Microenvironment-related indicators of tumor inflammation | Concentrations of signal transducer and activator of transcription 3 (STAT3) |
| Measure | Description | Time Frame |
|---|---|---|
| Comprehensive blood index | Values for NLDA (NLDA = neutrophil count/lymphocyte count × D-dimer count/albumin) | 10 minutes before anesthesia and 24 hours after the procedure |
| Comprehensive blood index |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yongtao Gao, Master | Affiliated Hospital of Nantong University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Affiliated hospital of Nantong University | Nantong | Jiangsu | 226001 | China |
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| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
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| 10 minutes before anesthesia, 1 hour and 24 hours after the procedure |
| Microenvironment-related indicators of tumor inflammation | Concentrations of Protooncogene tyrosine protein kinase (C-Src) | 10 minutes before anesthesia, 1 hour and 24 hours after the procedure |
| Microenvironment-related indicators of tumor inflammation | Concentrations of matrix metalloproteinases 2 (MMP-2) | 10 minutes before anesthesia, 1 hour and 24 hours after the procedure |
| Microenvironment-related indicators of tumor inflammation | Concentrations of matrix metalloproteinases 9 (MMP-9) | 10 minutes before anesthesia, 1 hour and 24 hours after the procedure |
Values for PDM (PDM = platelet× D-dimer count)
| 10 minutes before anesthesia and 24 hours after the procedure |
| Comprehensive blood index | Values for SII (SII= platelet× neutrophil / lymphocyte count) | 10 minutes before anesthesia and 24 hours after the procedure |
| Comprehensive blood index | Values for PNI (PNI = albumin + 5 × lymphocytes) | 10 minutes before anesthesia and 24 hours after the procedure |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |