Optimal Level of PEEP in Protective One-lung Ventilation

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Seoul National University

Status

Completed

Conditions

Video-assisted Thoracic Surgery
Positive End-expiratory Pressure
Postoperative Atelectasis

Treatments

Procedure: PEEP 9 cm of water
Procedure: PEEP 3 cm of water
Procedure: PEEP 6 cm of water

Study type

Interventional

Funder types

Other

Identifiers

NCT03856918
H-1901-086-1004

Details and patient eligibility

About

Protective ventilation strategy has been widely applied in the field of thoracic surgery requiring one-lung ventilation to reduce postoperative pulmonary complications. Low tidal volume, positive end-expiratory pressure (PEEP), and intermittent recruitment maneuver are key components of protective ventilation strategy. Recent evidence suggests that a tidal volume of 4-5 ml/kg should be applied during protective one-lung ventilation. However, optimal level of PEEP is still unclear. This study aims to investigate optimal level of PEEP to minimize postoperative atelectasis by comparing modified lung ultrasound score in patients applied protective one-lung ventilation using PEEP of 3, 6, or 9 cm of water during thoracic surgery.

Enrollment

142 patients

Sex

All

Ages

19 to 80 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients undergoing Video-assisted Thoracic Surgery under one-lung ventilation

Exclusion criteria

  • Moderate to severe obstructive/restrictive pattern in preoperative pulmonary function test
  • Chronic kidney disease
  • Coronary artery disease
  • Pulmonary hypertension
  • Bilateral lung surgery
  • Conversion to thoracotomy
  • American Society of Anesthesiologists physical status IV or more
  • Refusal to participate

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Triple Blind

142 participants in 3 patient groups

PEEP 3 cm of water
Experimental group
Description:
Patients allocated in this group will be applied protective one-lung ventilation using tidal volume of 5 ml/kg predicted body weight with PEEP of 3 cm of water during thoracic surgery.
Treatment:
Procedure: PEEP 3 cm of water
PEEP 6 cm of water
Experimental group
Description:
Patients allocated in this group will be applied protective one-lung ventilation using tidal volume of 5 ml/kg predicted body weight with PEEP of 6 cm of water during thoracic surgery.
Treatment:
Procedure: PEEP 6 cm of water
PEEP 9 cm of water
Experimental group
Description:
Patients allocated in this group will be applied protective one-lung ventilation using tidal volume of 5 ml/kg predicted body weight with PEEP of 9 cm of water during thoracic surgery.
Treatment:
Procedure: PEEP 9 cm of water

Trial contacts and locations

0

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Data sourced from clinicaltrials.gov

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