The role of protective intra-operative ventilation with alveolar recruitment strategies in minimising acute lung injury in lung transplantation.
Monash UniversityDataset description
Pressure-controlled ventilation 16cmH2O, repeated recruitment manoeuvres, positive end-expiratory pressure 10cmH2O with a tidal volume limit of 10ml/kg for two-lung ventilation and 6ml/kg for one-lung ventilation. The respiratory rate will be titrated to control partial pressures of carbon dioxide, from allograft insertion to end of surgeryDate Information
Identifiers
Source Study
Purpose:
Phase:
Trial acronym
Trial ID
ACTRN12612000403831
Funding
Scientific enquiries
Prof Professor Paul Myles
Brief Summary
Single-centre, randomised-controlled trial with a comparison of two protective ventilation techniques in order to determine the effect on the incidence of acute lung injury/ischaemia-reperfusion injury. Primary aims: 1. To determine the incidence and severity of acute lung injury post lung transplantation. 2. To determine the incidence of inflammatory markers in serum and bronchoalveolar lavage samples during anf after lung transplantation 3. To analyse the association between inflammatory marke .... Read more
Key Inclusion Criteria
Patient presenting for bilateral sequential lung transplantation
Key Exclusion Criteria
Single lung transplantation or combined heart-lung procedure. Planned use of cardiopulmonary bypass - severe pulmonary hypertension (mean pulmoary artery pressure > 60 mmHg) or significant right ventricular dysfunction.
Can healthy volunteers participate?
No
Population
Sample Size 33
Min. age 18 Years
Max. age 0 No limit
Sex Both males and females
Condition category Lung transplantation , respiratory
Condition code Anaesthesiology , Respiratory
Intervention
Intervention code Treatment: Other , Treatment: Surgery
Pressure-controlled ventilation 16cmH2O, repeated recruitment manoeuvres, positive end-expiratory pressure 10cmH2O with a tidal volume limit of 10ml/kg for two-lung ventilation and 6ml/kg for one-lung ventilation. The respiratory rate will be titrated to control partial pressures of carbon dioxide, from allograft insertion to end of surgery
Comparison
Control group Active
Low tidal volume ventilation (6ml/kg for two-lung ventilation, 4ml/kg for one-lung ventilation) / positive end-expiratory pressure 5mmHg. The respiratory rate will be titrated to control partial pressures of carbon dioxide, from allograft insertion to end of surgery.
Outcomes
Outcome: Partial pressure of oxygen (PaO2): Fraction of inspired oxygen (FiO2) ratio - indicating incidence and severity of acute lung injury. Completed by blood gass, and documentation of the FiO2 at the relevant timepoints.Timepoint: 0, 1, 2, 6 and 12 hours post surgical completion of lung transplant.