Nomogram for Prediction of Alveolo-arterial Gradient During One-lung Ventilation

NCT06376123 | Completed

• 1 other identifier: Nkangarli001
• Study Type: observational
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

The cause of hypoxia during one-lung ventilation is a common anaesthetic problem seen during thoracic surgery and is associated with increased fraction of shunted blood. This shunt occurs because the lung not participating in respiration stops saturating the blood with oxygen. The importance of our study is to collect some of the patient's parameters on a nomogram in the preoperative period, to predict the shunt fraction that will occur during one-lung ventilation and to make preparations and interventions accordingly.

Conditions

One-lung Ventilation

Keywords

One lung ventilation; Alveolo-arterial gradient; Nomograms

Outcome Measures

Primary Outcomes (1)

• Alveolo-arterial gradient

  The gradient of oxygen concentration between alveoli and arterial blood, achieved after patient switch from double lung to one lung lung ventilation. Is calculated automatically, based on oxygen tension in arterial and venous blood, which measured by blood gas analysis.

  30 mins after intubation

Secondary Outcomes (1)

• Alveolo-arterial gradient change

  After switching to one lung ventilation

Study Arms (1)

Video assisted thoracoscopic surgery patients

Patients, assigned for elective lung surgery, older than 18 years and requiring one-lung ventilation.

Eligibility Criteria

• Age: 18 Years - 100 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study includes patients with pulmonary diseases, indicated for surgery. Among them are pulmonectomy, segmentectomy, lobectomy or wedge resections. All these types of surgery require one-lung (non-operating lung) ventilation. The patients should be electively operated, aged more that 18 years and must have no other pulmonary conditions (like fibrosis, pneumonia, lung oedema or interstitial lung disease) that could interfere with Alveolo-arterial gradient calculations.

You may qualify if:

• Patients scheduled for elective VATS surgery.
• Age over 18 years.
• ASA 1-4 patients.

You may not qualify if:

• Patient refusal.
• Age below 18 years.
• Conditions that may impair oxygen diffusion: pulmonary oedema, fibrosis, interstitial lung disease, pneumonia.
• Emergency surgery.

Sponsors & Collaborators

• Bezmialem Vakif University: lead
• Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital: collaborator

Study Sites (1)

Bezmialem Vakif University Dragos Hospital

Istanbul, Maltepe, 34844, Turkey (Türkiye)

Location

Related Publications (3)

• Parab SY, Chatterjee A, Saxena RS. The utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- A prospective observational study. Indian J Anaesth. 2021 Oct;65(10):744-749. doi: 10.4103/ija.ija_591_21. Epub 2021 Oct 29.

  PMID: 34898701 BACKGROUND

• Karzai W, Schwarzkopf K. Hypoxemia during one-lung ventilation: prediction, prevention, and treatment. Anesthesiology. 2009 Jun;110(6):1402-11. doi: 10.1097/ALN.0b013e31819fb15d.

  PMID: 19417615 BACKGROUND

• Alday E, Nieves JM, Planas A. Oxygen Reserve Index Predicts Hypoxemia During One-Lung Ventilation: An Observational Diagnostic Study. J Cardiothorac Vasc Anesth. 2020 Feb;34(2):417-422. doi: 10.1053/j.jvca.2019.06.035. Epub 2019 Jun 28.

  PMID: 31362907 BACKGROUND

Study Officials

• Nigar Kangarli, MD

  Anesthesiology and Reanimation Department, Specialist

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Target Duration: 2 Days
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Medical Doctor, Anesthesiologist

Study Record Dates

• First Submitted: April 17, 2024
• First Posted: April 19, 2024
• Study Start: June 1, 2024
• Primary Completion: November 1, 2024
• Study Completion: November 1, 2024
• Last Updated: December 24, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)