Permissive Hypercapnia During One Lung Ventilation: Impact on Right Ventricular Systolic and Diastolic Functions During Lung Resection

Cairo University (CU)

Status: Completed

Conditions: Anesthesia

Treatments: Procedure: Permissive hypercapnia

Study type: Interventional

Funder types: Other

Identifiers

NCT02519517

acute permissive hypercapnia

Details and patient eligibility

About

Investigators studied 15 patients scheduled for pulmonary resection through thoracotomy. Initial tidal volume (VT) 10ml kg-1 was reduced to 8ml kg-1 after one lung ventilation (OLV) and the rate adjusted to maintain partial pressure of arterial carbon dioxide (PaCO2) 30-35 mm Hg. Data were obtained at: T1, 15 min post establishing OLV with normocapnia, T2, 15 min post establishing OLV with hypercapnia (PaCO2 7.98kPa (60mmHg) and 9.31kPa (70mmHg) and pH >7.1), and T3, 15 min after resuming OLV with normocapnia. One-way repeated measures analysis of variance (ANOVA), with post hoc Dunnet´s test were used for analysis. A P value < 0.05 is considered statistically significant.

Full description

Investigators studied 15 patients scheduled for elective pulmonary resection through thoracotomy. Patients had a standardized management for thoracotomies. Initial VT 10ml/ kg was reduced to 8ml/kg after OLV and the rate adjusted to maintain PaCO2 30-35 mm Hg. Haemodynamic, respiratory variables and echocardiographic data (Tei index and TAPSE) were obtained at: T1, 15 min post establishing OLV with normocapnia, T2, 15 min post establishing OLV with hypercapnia (PaCO2 7.98kPa (60mmHg) and 9.31kPa (70mmHg) and pH >7.1), and T3, 15 min after resuming OLV with normocapnia. One-way repeated measures ANOVA, with post hoc Dunnet´s test were used for analysis. A P value < 0.05 is considered statistically significant.

Enrollment: 15 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• adult >18 yr
• elective pulmonary resection through thoracotomy.

Exclusion criteria

• Patients with pulmonary hypertension (systolic >50mmHg),
• intracranial hypertension or previous intracranial haemorrhage,
• pre-existing hypercapnia,
• co-existing metabolic acidosis,
• ischaemic heart disease,
• predicted postoperative FEV1<800 ml or <40% of the expected in pneumonectomy
• patient in which transesophageal echocardiography was contraindicated or necessary measurements were difficult to assess.

Trial design

Primary purpose: Screening

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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15 participants in 1 patient group

permissive hypercapnia

Experimental group

Description:

during one lung ventilation, right ventricular function was assessed by TEE and the effect of rising PCO2 appreciated

Treatment:

Procedure: Permissive hypercapnia