Electrical Impedance Tomography in One-Lung Ventilation
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|ClinicalTrials.gov Identifier: NCT03728010|
Recruitment Status : Recruiting
First Posted : November 1, 2018
Last Update Posted : July 9, 2021
Mechanical ventilation can cause damage to the lung parenchyma, this is known as ventilatory induce lung injury (VILI).To avoid this damage, ventilatory strategies have been created, focused on the reduction of tidal volume, airway pressures and use of PEEP (positive end-expiratory pressure), which together are called "protective ventilation".
Although ventilation with protective parameters seems to reduce VILI in one-lung ventilation, the optimal parameters are not clear.
|Condition or disease||Intervention/treatment|
|Ventilator Lung||Diagnostic Test: Electrical impedance tomography. Pulmonary mechanics measurement.Arterial gas measurement. Esophageal pressure measurement|
This research aims to describe the ventilation, perfusion and pulmonary mechanics on one-lung ventilation with different levels of tidal volume and PEEP.
An extreme situation of VILI occurs in thoracic surgery, where the atelectasis of a lung is required, ventilating throughout the surgery only the contralateral one. This generates an inflammatory state, with the release of alveolar cytokines from both the non-ventilated and ventilated lungs, which potentiates the development of damage in the lung parenchyma. In addition, one lung ventilation has traditionally been performed with high tidal volume (Vt) values and low PEEP. In this context, the development of VILI is even more probable, so extreme measures of protection in this kind of ventilation are necessary.
The electrical impedance tomography will allow the investigators to obtain a visual and quantitative representation of the areas of ventilation and perfusion of the lung. By relating the tidal volume and PEEP with the tomographic results, it is expected to define mechanical ventilation parameters that achieve the best ventilation/perfusion ratio for patients in one-lung ventilation. Specifically, analyze the distribution and deformation of the ventilated areas in the different lung regions and its correlation with respiratory mechanics and volumetric capnography. This will allow the investigators to make a better definition of the tidal volume and PEEP in patients undergoing one-lung ventilation.
|Study Type :||Observational|
|Estimated Enrollment :||20 participants|
|Official Title:||Tidal Volume and PEEP Titration in One-Lung Ventilation With Electrical Impedance Tomography|
|Actual Study Start Date :||December 7, 2018|
|Estimated Primary Completion Date :||December 2021|
|Estimated Study Completion Date :||December 2021|
Thoracic surgery cases with one-lung ventilation strategy.
Diagnostic Test: Electrical impedance tomography. Pulmonary mechanics measurement.Arterial gas measurement. Esophageal pressure measurement
After general anesthesia, patients will be ventilated with three tidal volume level (4, 6 and 8 cc / Kg / IBW), in two levels of PEEP, 6 cm2 H20, and best PEEP, the latter obtained after a recruitment maneuver and decremental titration.
- Ventilation/ perfusion ratio [ Time Frame: 1 hour ]Electrical impedance tomography.
- Pulmonary mechanics [ Time Frame: 1 hour ]Airway pressure ,esophageal pressure measurement.
- Arterial gas measurement [ Time Frame: 20 minutes ]5 samples per patient
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03728010
|Contact: Roberto Gonzalez, MDemail@example.com|