The Open Lung Approach During One Lung Ventilation in Thoracic Surgery

Status Completed

Clinical Trial Summary

- Question: Ventilatory strategy to counterbalance the effect of one lung ventilation during thoracic surgery.

- Findings: the open lung approach improved oxygenation and lung compliance, reducing respiratory system driving pressure and transpulmonary driving pressure.

- Meaning: patients undergoing thoracic surgery during one lung ventilation may benefit of an open lung approach strategy to avoid ventilator lung injury.

Clinical Trial Description

Background: During thoracic surgery in lateral decubitus, one lung ventilation (OLV) may impair respiratory mechanics and gas exchange. The investigators tested a strategy based on an open lung approach (OLA) consisting in lung recruitment immediately followed by a decremental positive-end expiratory pressure (PEEP) titration to the best respiratory system compliance (CRS) and separately quantified the elastic properties of the lung and the chest wall. The investigators hypothesis was that this approach would improve gas exchange and increase lung compliance (CL).

Methods: In thirteen patients undergoing upper left lobectomy the investigators studied lung and chest wall mechanics, transpulmonary pressure (PL), respiratory system and transpulmonary driving pressure (ΔPRS and ΔPL), gas exchange and hemodynamics at two time-points (a) during OLV at zero end-expiratory pressure (OLVpre-OLA) and (b) after the application of the open-lung strategy (OLVpost-OLA). ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT03435523
Study type	Interventional
Source	University of Foggia
Contact
Status	Completed
Phase	N/A
Start date	February 1, 2012
Completion date	November 30, 2012

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