Hypoxemia Clinical Trial
Official title:
The Efficacy of Driving Pressure-guided Lung Protective Ventilation in Surgical Repair of Acute Type A Aortic Dissection: an Open-label, Randomized Control Clinical Trial
The study, named as "The Efficacy of Driving Pressure-guided Lung Protective Ventilation in Surgical Repair of Acute Type A Aortic Dissection: an open-label, randomized control clinical trial", aims to investigate whether driving pressure-guided lung protective ventilation can reduce postoperative oxygenation function in patients who have undergone surgical repair of acute type A aortic dissection. The primary outcomes is the incidence of postoperative hypoxemia (a partial pressure of arterial oxygen to inspiratory oxygen fraction ratio less than 300 mm Hg or a peripheral blood oxygen saturation less than 93% at any concentration of inspiratory oxygen) within 7 days after the surgery.
Postoperative hypoxemia is defined as a partial pressure of arterial oxygen to inspiratory oxygen fraction ratio less than 300 mm Hg or a peripheral blood oxygen saturation less than 93% at any concentration of inspiratory oxygen. Acute type A aortic dissection is a lethal disease requiring emergency surgery. Compared with non-cardiac surgery, hypoxemia frequently occurs after surgical repair for acute type A aortic dissection which has been reported to be 52%-67.6%, and the possible mechanisms are as followed: (1) systemic inflammatory reaction induced by massive thrombosis formation and long duration of extracorporeal circulation; (2) ischemia-perfusion injury in lung; and (3) a massive perioperative transfusion. Postoperative hypoxemia has been reported to be associated with prolonged duration of extubation, length of stay in ICU and respiratory failure, which contributes a high mortality of 20% to 44%. Driving pressure, defined as the difference between platform airway pressure and positive end-expiratory pressure, was first introduced by Amato and his colleagues in their meta-analysis study on acute respiratory distress syndrome in 2015, demonstrating that driving pressure was most strongly associated with survival among various ventilation parameters. A lower driving pressure has been verified to be closely relative to an ameliorative prognosis after surgery. However, controversy persists regarding whether driving pressure-guided ventilation can decrease the incidences of postoperative hypoxemia and other pulmonary complications in the patients underwent surgical repair of acute type A aortic dissection. Given the need for additional evidence to confirm the relationship between driving pressure and postoperative hypoxemia in the patients with acute type A aortic dissection, this open-label, randomized control clinical trial aims to assess the efficacy and safety of the driving pressure-guided lung protective ventilation strategy in preventing hypoxemia and other pulmonary complications after the surgical repair for acute type A aortic dissection. ;
Status | Clinical Trial | Phase | |
---|---|---|---|
Suspended |
NCT03628560 -
Alternate Methodology of Pulse Oximeter Validation
|
N/A | |
Completed |
NCT02866578 -
Open Lung Protective Ventilation in Cardiac Surgery
|
N/A | |
Recruiting |
NCT06139081 -
Oxygen Delivery Methods of Nasal Catheter on the Incidence of Hypoxemia in Patients With Painless Gastroscopy
|
N/A | |
Not yet recruiting |
NCT05964309 -
Pre-oxygenation in Sitting Position and Oxygen Reserve Index
|
N/A | |
Completed |
NCT00740220 -
Reproducibility of 6 Minute Walk Tests for Oxygen Desaturation
|
N/A | |
Completed |
NCT00675415 -
Does Capnography Prevent Hypoxemia During Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound?
|
N/A | |
Completed |
NCT04557605 -
Effects of a Face Mask on Oxygenation During Exercise
|
N/A | |
Active, not recruiting |
NCT05479929 -
Work of Breathing Assessment in Triage Scale
|
||
Recruiting |
NCT05422430 -
Rebreathing-induced Hypoxia and Glucose Levels
|
N/A | |
Recruiting |
NCT03009643 -
Salvage Treatment of Inhaled Nitric Oxide in Patients With Refractory Hypoxemia After Aortic Surgery
|
N/A | |
Completed |
NCT01949012 -
Capnography Monitoring During Intravenous Conscious Sedation Sedation With Midazolam for Oral Surgery
|
N/A | |
Completed |
NCT01477450 -
Comparison of Oxygen Delivery Devices for Reversal of Altitude-Induced Hypoxemia in Normal Subjects
|
N/A | |
Completed |
NCT01470170 -
Regimen of Alfentanil in Propofol Sedative Fibro-bronchoscopy
|
Phase 4 | |
Recruiting |
NCT06085859 -
Anesthesia Endoscope Mask is Applied to Sedation Upper Gastrointestinal Endoscopic Diagnosis and Treatment
|
N/A | |
Recruiting |
NCT03969615 -
SuperNO2VA™ and General Anesthesia Postoperative Care
|
N/A | |
Completed |
NCT02554110 -
Peripheral Nerve Stimulation to Reduce Hypoxic Events
|
N/A | |
Completed |
NCT04998253 -
Effects in Oxygenation and Hypoxic Pulmonary Vasoconstriction in ARDS Secondary to SARS-CoV2
|
Early Phase 1 | |
Completed |
NCT04566419 -
poStoperative Anesthesia Care: Facial Mask vs Hfnc and Thoracic Ultrasound for Reduction of Atelectasis Incidence
|
N/A | |
Recruiting |
NCT04079465 -
Automated Oxygen Control by O2matic to Patients Admitted With Acute Hypoxemia
|
N/A | |
Recruiting |
NCT06022523 -
Accuracy of Pulse Oximeters With Profound Hypoxia
|
N/A |