Rationale and Study Design for an Individualized Perioperative Open Lung Ventilatory Strategy in Patients on One-Lung Ventilation (iPROVE-OLV)

Autor: Carramiñana A, Ferrando C, Unzueta MC, Navarro R, Suárez-Sipmann F, Tusman G, Garutti I, Soro M, Pozo N, Librero J, Gallego L, Ramasco F, Rabanal JM, Rodriguez A, Sastre J, Martinez J, Coves S, García P, Aguirre-Puig P, Yepes J, Lluch A, López-Herrera D, Leal S, Vives M, Bellas S, Socorro T, Trespalacios R, Salazar CJ, Mugarra A, Cinnella G, Spadaro S, Futier E, Ferrer L, Cabrera M, Ribeiro H, Celestino C, Kucur E, Cervantes O, Morocho D, Delphy D, Ramos C, Villar J, iPROVE-OLV Network, Belda J
Jazyk: angličtina
Rok vydání: 2019
Předmět:
medicine.medical_specialty
Internationality
one-lung ventilation
medicine.medical_treatment
Atelectasis
030204 cardiovascular system & hematology
Lung injury
mechanical ventilation
medicine.disease_cause
Perioperative Care
NO
recruitment maneuvers
Positive-Pressure Respiration
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
030202 anesthesiology
medicine
Humans
Single-Blind Method
Prospective Studies
Precision Medicine
mechanical ventilation
one-lung ventilation
positive end-expiratory pressure
postoperative pulmonary complications
recruitment maneuvers
Mechanical ventilation
Thoracic Surgery
Video-Assisted
business.industry
Perioperative
respiratory system
medicine.disease
Anesthesiology and Pain Medicine
Pneumothorax
Cardiothoracic surgery
Anesthesia
postoperative pulmonary complications
Intraoperative Period
Cardiology and Cardiovascular Medicine
business
Nasal cannula
positive end-expiratory pressure
Zdroj: JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname
ISSN: 1053-0770
Popis: Objective The aim of this clinical trial is to examine whether it is possible to reduce postoperative complications using an individualized perioperative ventilatory strategy versus using a standard lung-protective ventilation strategy in patients scheduled for thoracic surgery requiring one-lung ventilation. Design International, multicenter, prospective, randomized controlled clinical trial. Setting A network of university hospitals. Participants The study comprises 1,380 patients scheduled for thoracic surgery. Interventions The individualized group will receive intraoperative recruitment maneuvers followed by individualized positive end-expiratory pressure (open lung approach) during the intraoperative period plus postoperative ventilatory support with high-flow nasal cannula, whereas the control group will be managed with conventional lung-protective ventilation. Measurements and Main Results Individual and total number of postoperative complications, including atelectasis, pneumothorax, pleural effusion, pneumonia, acute lung injury; unplanned readmission and reintubation; length of stay and death in the critical care unit and in the hospital will be analyzed for both groups. The authors hypothesize that the intraoperative application of an open lung approach followed by an individual indication of high-flow nasal cannula in the postoperative period will reduce pulmonary complications and length of hospital stay in high-risk surgical patients.
Databáze: OpenAIRE
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