High PEEP Application Following Pulmonary Thromboendarterectomy; Does it Have Any Impact on Outcome?

Kartal Kosuyolu Yuksek Ihtisas Education and Research Hospital

Status: Completed

Conditions: Reperfusion Injury After Pulmonary Thromboendarterektomy

Treatments: Other: PEEP; Other: control group

Study type: Interventional

Funder types: Other

Identifiers

NCT03806504

2018/6/62

Details and patient eligibility

About

Investigation of the effect of intraoperative lung protection high PEEP maneuver on ischemic reperfusion injury in patients undergoing pulmonary endarterectomy.

Full description

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease characterized by progression of thromboembolism obstructing pulmonary arteries as an organized tissue. Pulmonary thromboendarterectomy (PTE) is a treatment option for chronic thromboembolic pulmonary disease. However, PTE is associated with specific postoperative complications, such as pulmonary edema and right ventricular failure due to reperfusion injury, with a significant mortality rate of 7% to 24%. Some strategies have been proposed to reduce lung injury after PTE, such as rectification maneuvers and high PEEP. The aim of this study was to investigate the effect of intraoperative lung protection high PEEP maneuver in patients undergoing pulmonary endarterectomy for ischemic reperfusion injury.

Enrollment: 60 patients

Sex: All

Ages: 20 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients undergoing elective PTE operation due to CTEPH,
• 20-70 years old

Exclusion criteria

• Patients with chronic inflammatory disease,
• liver and renal failure,
• heart failure (<EF: 40%),
• intraoperative bronchial hemorrhage,
• patients undergoing postoperative revision.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

high PEEP

Active Comparator group

Description:

35 cm/H2O PEEP, 2-3 ml/kg tidal volume,45 seconds, after cardiopulmonary bypass

Treatment:

Other: PEEP

control group

Active Comparator group

Description:

6 cm/H2O PEEP, 6-8 ml/kg tidal volume, continues, after cardiopulmonary bypass

Treatment:

Other: control group