The Effect of Semi-recumbent Position on Hypoxemia After Lung Segment/Lobe Surgery

NCT07060625 | Enrolling By Invitation

• 1 other identifier: L24-629
• Study Type: observational
• Target: 308
• Locations: 1 country
• Sites: 1

Brief Summary

Thoracoscopic surgery is the most common surgical approach in thoracic surgery, which reduces surgical trauma and postoperative pain compared with open thoracotomy, but postoperative complications should not be overlooked, with hypoxemia being particularly prominent. Postoperative hypoxemia is highly prevalent among patients recovering from non-cardiac surgery, accounting for over one-third of all cases. Hypoxemia impairs wound healing and leads to other severe complications such as cerebral dysfunction, arrhythmia, and myocardial ischemia, all of which adversely affect postoperative recovery. Although oxygen therapy can prevent and treat hypoxemia, many patients still experience hypoxia in the post-anesthesia care unit (PACU). Numerous studies have investigated various ventilation techniques aimed at enhancing postoperative pulmonary function, but the benefits of protective ventilation strategies may be lost during emergence from anesthesia. Several other studies also indicate that intraoperative ventilation measures do not improve postoperative pulmonary function. The lack of evidence demonstrating the efficacy of oxygen therapy or protective ventilation techniques in treating postoperative hypoxemia underscores the need to explore alternative strategies. Patient positioning during emergence from anesthesia is associated with perioperative and postoperative complications. Although no consensus exists on the optimal patient position during emergence, the supine position is often favored by anesthesiologists due to its simplicity and ease of monitoring. However, the reduced functional residual capacity associated with the supine position tends to promote airway closure and diminish gas exchange.

Conditions

Lung Cancer (Diagnosis); Hypoxemia

Outcome Measures

Primary Outcomes (1)

• Incidence of post-PACU hypoxemia

  defined as SpO2 \<90% for less than 60 seconds

  Perioperative

Secondary Outcomes (9)

• The incidence of severe hypoxemia

  Perioperative

• the time of the first episode of hypoxemia

  Perioperative

• Airway first aid

  Perioperative

• Breathing comfort

  Perioperative

• Wound pain VAS score

  measured and recorded at rest and cough, 5 and 30 minutes after extubation, before leaving PACU and 24,48 and 72 hours postoperative

Other Outcomes (4)

• Adverse events related to position

  Perioperative

• 15-item recovery quality scale (Quality of Recovery-15, QoR-15) scores

  at 1 and 3 days postoperative

• Postoperative inflammatory markers

  On the first day after surgery

Study Arms (2)

Exposure group

Semi-recumbent position during anesthesia recovery

Behavioral: Semi-reclining position

Non exposed group

Supine position during anesthesia recovery

Interventions

Semi-reclining position BEHAVIORAL

During anesthesia recovery, the patient's position should be in a semi-recumbent position

Exposure group

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Patients undergoing thoracoscopic lobectomy and segmental resection

You may qualify if:

• Age 18-85 years old; Undergo thoracoscopic segment/lobectomy; American Society of Anesthesiologists (ASA) grade 1\~3

You may not qualify if:

• Patients with mental or cognitive dysfunction who cannot communicate normally; Patients with tracheal catheters retained in ICU; Patients with cervical spondylosis, ankylosing spondylitis and other patients who cannot lift their upper body; Patients who have participated in other clinical trials; Patients who refuse to sign informed consent; Patients who have had chest surgery in the past.

Sponsors & Collaborators

• Shanghai Pulmonary Hospital, Shanghai, China: lead

Study Sites (1)

Shanghai Pulmonary Hospital

Shanghai, Shanghai Municipality, 200090, China

Location

MeSH Terms

Conditions

Lung Neoplasms; Disease; Hypoxia

Condition Hierarchy (Ancestors)

Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms, Respiratory; Signs and Symptoms

Study Officials

• Yang Hao, postdoctor

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 308 Days
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: post-doctoral

Study Record Dates

• First Submitted: June 23, 2025
• First Posted: July 11, 2025
• Study Start: December 23, 2024
• Primary Completion: December 22, 2025
• Study Completion (Estimated): September 30, 2026
• Last Updated: July 11, 2025

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)