Effect of Oxygen Administration in the Non-dependent Lung on Postoperative Complications After Lung Surgery
Impact of Continuous Oxygen Flow With or Without Airway Pressure in the Non-dependent Lung During One-lung Ventilation on Postoperative Complications in Lung Resection Surgery: A Randomized Controlled Clinical Trial
Francisco Andres de la Gala
177 participants
Jan 27, 2025
INTERVENTIONAL
Conditions
Summary
The purpose of this study is to analyze the effectiveness of apneic oxygenation and CPAP applied to the non-dependent lung during pulmonary resection surgery in reducing inflammatory response, ischemia-reperfusion injury, and postoperative complications. We will conduct a randomized, controlled, and blinded study in 177 patients with three arms: * Control Group: Oxygen therapy according to standard clinical practice * Apneic oxygenation group: A probe will be introduced through the lumen of the double-lumen tube (DLT) to administer a continuous source of oxygen without any mechanism that generates airway pressure. * CPAP Group: Continuous positive airway pressure with 3-5 L/min oxygen flow and 2 cm H2O pressure delivered via a Mapleson system. Inflammatory mediators in blood and in both lungs will be measured intraoperatively and 24 hours after surgery. Patients will be followed from hospital admission until discharge and again 30 days after surgery to evaluate the postoperative course, particularly the occurrence of complications according to the revised Clavien-Dindo classification for thoracic surgery, as well as other relevant clinical outcomes.
Eligibility
Inclusion Criteria5
- Patients of both genders undergoing lung resection surgery in the Thoracic Surgery Department at Hospital General Universitario Gregorio Marañón
- Lung isolation using a double-lumen tube (DLT)
- Scheduled surgery
- Patients able and willing to give written informed consent
- Patients over 18 years old and legally competent
Exclusion Criteria9
- Patients with evidence of pulmonary bullae
- Pregnancy or breastfeeding
- Blood transfusion within 10 days prior to surgery
- Treatment with immunosuppressants or corticosteroids within 3 months prior to surgery
- Patient refusal to participate
- Prior contralateral thoracic surgery
- Robotic surgery
- Pneumonectomy
- Enrollment in another clinical trial
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Interventions
Medicinal gas, compressed. Oxygen 99.5% v/v
Continuous positive pressure
Ambient air connection
Locations(1)
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NCT07461779