Cardiopulmonary Effects of Intrathoracic Pressure Overshoot During Carbon Dioxide Insufflation in Thoracoscopic Surgery

Video-assisted thoracoscopic surgery (VATS) has become a standard technique for addressing all types of thoracic pathology. Insufflation of carbon dioxide (CO2) into the operated chest cavity could increase lung collapse and improve surgical field view. The actual thoracic pressure values may not be identical with the presetting on the insufflator display. This overshoot pressure during VATS may compromise cardiac and pulmonary function. The purpose of this study is to evaluate the effects of intrathoracic pressure overshoot during two-lung ventilation on the hemodynamic and respiratory function and clarify the relative safety of two different techniques of insufflation.

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Key information

Conditions

Esophageal Neoplasms Digestive System Diseases Digestive System Neoplasms Esophageal Diseases Gastrointestinal Diseases Gastrointestinal Neoplasms Head and Neck Neoplasms Neoplasms Neoplasms by Site

Age range

20 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

American Society of Anesthesiologists (ASA) Physical Status Ⅰ,Ⅱ
Patients with esophageal carcinoma
Elective video-assisted thoracic surgery

Exclusion criteria

Allergic to drugs used in the study
Refusal of VAST
Arrhythmia or treated with antiarrhythmic drug
Surgery type were converted to thoracotomy,
Massive intraoperative blood loss (> 400ml)

Treatment and study plan

Insufflation of carbon dioxide (CO2)

Device

After patients were positioned, CO2 was insufflated into right pleural cavity at eight or twenty L/min. during video-assisted thoracoscopic surgery, thoracic pressure, hemodynamic and respiratory parameters were recorded.

Primary outcomes

thoracic pressure overshoot

Time frame: one hour during CO2 insufflation

Time and value of thoracic pressure overshoot during CO2 insufflation
Hemodynamic change

Time frame: one hour during CO2 insufflation

Hemodynamic changes during each overshoot including Systolic Blood Pressure, Central Venous Pressure and Heart Rate
Respiratory change

Time frame: one hour during CO2 insufflation

Respiratory changes during each overshoot including Peak Inspiratory Pressure, Pressure flat, Arterial Oxygen Saturation and End-tidal Carbon dioxide

Sponsors and collaborators

Lead sponsor

Daping Hospital and the Research Institute of Surgery of the Third Military Medical University

Other

Registry information

Important dates

Study start: 2014
Primary completion: 2020
Study completion: 2020
First posted: Jan 5, 2015
Registry last updated: Feb 24, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed