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The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing One-lung Ventilation for Lung Surgery

20 Years
70 Years
Open (Enrolling)
Lung Cancer, One Lung Ventilation, Gas Exchange, Inverse-ratio Ventilation

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Trial Information

The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing One-lung Ventilation for Lung Surgery

Pulmonary gas exchange disturbance is a common anesthetic problem during one-lung
ventilation (OLV) for thoracic surgery. Continuous positive airway pressure or positive
end-expiratory pressure are usually applied to improve this disorder including hypoxia, but
these methods are not enough. The inverse-ratio ventilation (IRV), which prolongs the
inspiratory time greater than expiratory time, can be applied for adult respiratory distress
syndrome. The effect of IRV is to improve gas-exchange status by increasing mean airway
pressure and alveolar recruitment. The application of IRV during OLV has not been performed
to our knowledge, and there is a possibility of IRV to improve oxygenation during OLV. There
is a possibility of increase of auto-PEEP, or air trapping in subjects with chronic
obstructive pulmonary disease, but this kind of auto-PEEP can be overcome by external PEEP.
Therefore, we tried to evaluate the effect of IRV during OLV with lung protective strategy.

Inclusion Criteria:

- patients undergoing elective lung lobectomy surgery.

- the duration of one-lung ventilation is more than one hour.

- subjects with more than twenty years old.

Exclusion Criteria:

- subjects with past history of pneumothorax, asthma

- Age under 20, more than 70 years.

- Patients with ischemic heart disease, valvular heart disease

- patients with hemodynamic unstability

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor)

Outcome Measure:

arterial CO2 partial pressure

Outcome Description:

arteial CO2 partial pressure

Outcome Time Frame:

10 minutes after induction of general anesthesia

Safety Issue:


Principal Investigator

Sangmin M. Lee, MD, PhD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Samsung Medical Center


South Korea: Institutional Review Board

Study ID:




Start Date:

February 2012

Completion Date:

October 2012

Related Keywords:

  • Lung Cancer
  • One Lung Ventilation
  • Gas Exchange
  • Inverse-ratio Ventilation
  • one lung ventilation
  • gas exchange
  • inverse-ratio ventilation
  • Lung Neoplasms