Cardiopulmonary Effects of Intrathoracic Pressure Overshoot During Carbon Dioxide Insufflation in Thoracoscopic Surgery

Esophageal Neoplasms Clinical Trial

Official title:

Cardiopulmonary Effects of Intrathoracic Pressure Overshoot During Carbon Dioxide Insufflation in Thoracoscopic Surgery

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02330536
• Other study ID #: QMao
• Status: Completed
• Phase: N/A
• Start date: December 2014
• Est. completion date: July 2020

Study information

• Verified date: February 2021
• Source: Daping Hospital and the Research Institute of Surgery of the Third Military Medical University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Video-assisted thoracoscopic surgery (VATS) has become a standard technique for addressing all types of thoracic pathology. Insufflation of carbon dioxide (CO2) into the operated chest cavity could increase lung collapse and improve surgical field view. The actual thoracic pressure values may not be identical with the presetting on the insufflator display. This overshoot pressure during VATS may compromise cardiac and pulmonary function. The purpose of this study is to evaluate the effects of intrathoracic pressure overshoot during two-lung ventilation on the hemodynamic and respiratory function and clarify the relative safety of two different techniques of insufflation.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 232
• Est. completion date: July 2020
• Est. primary completion date: July 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 20 Years to 80 Years

Eligibility

Inclusion Criteria:

• American Society of Anesthesiologists (ASA) Physical Status ?,?
• Patients with esophageal carcinoma
• Elective video-assisted thoracic surgery

Exclusion Criteria:

• Allergic to drugs used in the study
• Refusal of VAST
• Arrhythmia or treated with antiarrhythmic drug
• Surgery type were converted to thoracotomy,
• Massive intraoperative blood loss (> 400ml)

Related Conditions & MeSH terms

• Esophageal Neoplasms

Intervention

Device:
• Insufflation of carbon dioxide (CO2)
After patients were positioned, CO2 was insufflated into right pleural cavity at eight or twenty L/min. during video-assisted thoracoscopic surgery, thoracic pressure, hemodynamic and respiratory parameters were recorded.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Daping Hospital and the Research Institute of Surgery of the Third Military Medical University

References & Publications (3)

Brock H, Rieger R, Gabriel C, Pölz W, Moosbauer W, Necek S. Haemodynamic changes during thoracoscopic surgery the effects of one-lung ventilation compared with carbon dioxide insufflation. Anaesthesia. 2000 Jan;55(1):10-6. — View Citation

Claus CM, Cury Filho AM, Boscardim PC, Andriguetto PC, Loureiro MP, Bonin EA. Thoracoscopic enucleation of esophageal leiomyoma in prone position and single lumen endotracheal intubation. Surg Endosc. 2013 Sep;27(9):3364-9. doi: 10.1007/s00464-013-2918-3. Epub 2013 Apr 3. — View Citation

El-Dawlatly AA, Al-Dohayan A, Abdel-Meguid ME, Turkistani A, Alotaiby WM, Abdelaziz EM. Variations in dynamic lung compliance during endoscopic thoracic sympathectomy with CO2 insufflation. Clin Auton Res. 2003 Dec;13 Suppl 1:I94-7. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	thoracic pressure overshoot	Time and value of thoracic pressure overshoot during CO2 insufflation	one hour during CO2 insufflation
Primary	Hemodynamic change	Hemodynamic changes during each overshoot including Systolic Blood Pressure, Central Venous Pressure and Heart Rate	one hour during CO2 insufflation
Primary	Respiratory change	Respiratory changes during each overshoot including Peak Inspiratory Pressure, Pressure flat, Arterial Oxygen Saturation and End-tidal Carbon dioxide	one hour during CO2 insufflation