Pulmonary Surgery and Protective Mechanical Ventilation
Extended description of the protocol could be provided by the URC-EST, SAINT ANTOINE
HOSPITAL, University of Paris-VI and by principal investigator.
Pneumonectomy or lobectomy is associated with a high risk for postoperative complication.
The benefit of lung protective ventilation with low tidal volume has been demonstrated in
patients with acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). Recent
clinical studies have suggested that mechanical ventilation with low tidal volume may also
profit in others setting. Lung protective ventilation during anaesthesia has been found to
limit the inflammatory response in the lung and to decrease postoperative systemic
inflammatory response. However, others trials did not found benefit of protective
ventilation strategy during anaesthesia.
This study will be a randomized, controlled, doubled blind trial comparing two management
ventilator strategies during anaesthesia for thoracotomy. Only patients undergoing
pneumonectomy or lobectomy for lung primitive cancer will be included in this trial. During
anesthesia, one group will receive mechanical ventilation with low tidal volume (5 ml/kg of
ideal body weight) plus PEEP and the other will receive tidal volume of 10 ml/kg of ideal
body weight without PEEP. After surgery, data concerning oxygen delivery, blood analysis,
complications, cancer recurrence and death will be collected.
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
Major postoperative complications during the first 30 days after surgery
the first 30 days after surgery
Emmanuel Marret, MD
Hopital Tenon, Assistance Publique - Hopitaux de Paris
France: Direction Générale de la Santé