Effect of Low Tidal Volume Ventilation in Improving Oxygenation and Thus Reducing Acute Lung Injury in the Cardiac Surgical Patient
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Purpose
We propose that as low tidal volume ventilation has proven to be beneficial in patients with established ARDS it may have a role in preventing the onset of acute lung injury in the cardiac surgical population. Institution of low tidal volume ventilation in the operating room may reduce the release of the cytokines and interleukins that have been known to contribute to the development of acute lung injury. In this study, we propose that the institution of low tidal volume ventilation in the operating room will reduce the incidence of acute lung injury. Measurement of PaO2 to FiO2 ratio twenty four and forty eight hours post operatively will help determine if there is a difference in oxygenation between the two groups. Chest X-ray findings, time to extubation and length of ICU stay will also determine if there is a role for low tidal volume ventilation in the operating room. We will also attempt to establish a causative mechanism by measuring plasma levels of cytokines known to be associated with the development of ARDS.
| Condition | Intervention |
|---|---|
|
Acute Respiratory Distress Syndrome |
Other: Ventilation strategy |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Effect of Low Tidal Volume Ventilation in Improving Oxygenation and Thus Reducing Acute Lung Injury in the Cardiac Surgical Patient |
- Time to extubation [ Designated as safety issue: No ]
- Oxygenation at 4 hours, 8 hours, 12 hours and 24 hours post surgery. [ Designated as safety issue: No ]
| Estimated Enrollment: | 120 |
| Study Start Date: | October 2007 |
| Study Completion Date: | January 2010 |
| Primary Completion Date: | October 2009 (Final data collection date for primary outcome measure) |
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients coming in for cardiac surgical procedures will be recruited into the study.
- Both men and women will be recruited into the study.
- All patients over the age of 18 will be recruited into the study.
- Discussion between the surgeon and the primary investigator will happen prior to approaching the patient to obtain informed consent.
Exclusion Criteria:
- Patients with preexisting respiratory failure and active infection will be excluded from the study.
- Patients undergoing one lung ventilation during surgery will be excluded from the study.
- Patients undergoing emergency cardiac surgery will be excluded from the study.
Contacts and Locations| United States, Massachusetts | |
| Beth Israel Deaconess Medical Center | |
| Boston, Massachusetts, United States, 02215 | |
| Study Director: | Daniel Talmor, MD | Beth Israel Deaconess Medical Center |
More Information
No publications provided
| Responsible Party: | Daniel Talmor MD, Beth Israel Deaconess Medical Center |
| ClinicalTrials.gov Identifier: | NCT00538161 History of Changes |
| Other Study ID Numbers: | 2007P000113 |
| Study First Received: | September 30, 2007 |
| Last Updated: | March 22, 2010 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Beth Israel Deaconess Medical Center:
|
Acute lung injury cardiac surgery The incidence of ARDS after elective cardiac surgery is 1-3% |
The impairment of lung function and oxygenation may occur in 20-80% of patients undergoing surgery. The purpose of this study is to assess the efficacy of low tidal volume ventilation. Reducing interleukin and cytokine production may prevent or reduce the incidence of acute lung injury. |
Additional relevant MeSH terms:
|
Respiratory Distress Syndrome, Newborn Respiratory Distress Syndrome, Adult Acute Lung Injury Lung Injury Lung Diseases Respiratory Tract Diseases |
Respiration Disorders Infant, Premature, Diseases Infant, Newborn, Diseases Thoracic Injuries Wounds and Injuries |
ClinicalTrials.gov processed this record on May 22, 2013