驱动压指导个体化肺保护通气在机器人辅助前列腺癌根治术中的应用研究

注册号:

Registration number:

ChiCTR2400081338 

最近更新日期:

Date of Last Refreshed on:

2024-02-28 16:40:31 

注册时间:

Date of Registration:

2024-02-28 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

驱动压指导个体化肺保护通气在机器人辅助前列腺癌根治术中的应用研究

Public title:

Driving pressure-guided individualized lung-protective ventilation in robot-assisted radical prostatectomy

注册题目简写:

English Acronym:

研究课题的正式科学名称:

驱动压指导个体化肺保护通气在机器人辅助前列腺癌根治术中的应用研究

Scientific title:

Driving pressure-guided individualized lung-protective ventilation in robot-assisted radical prostatectomy

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

蒋燕 

研究负责人:

蒋燕 

Applicant:

Yan Jiang 

Study leader:

Yan Jiang 

申请注册联系人电话:

Applicant telephone:

+86 199 2331 1078

研究负责人电话:

Study leader's
telephone:

+86 199 2331 1078

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

mzkjiang@163.com

研究负责人电子邮件:

Study leader's E-mail:

mzkjiang@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

重庆市沙坪坝区汉渝路181号

研究负责人通讯地址:

重庆市沙坪坝区汉渝路181号

Applicant address:

No.181, Hanyu Road, Shapingba District, Chongqing, China

Study leader's address:

No.181, Hanyu Road, Shapingba District, Chongqing, China

申请注册联系人邮政编码:

Applicant postcode:

400030

研究负责人邮政编码:

Study leader's postcode:

400030

申请人所在单位:

重庆大学附属肿瘤医院

Applicant's institution:

Chongqing University Cancer Hospital

研究负责人所在单位:

重庆大学附属肿瘤医院

Affiliation of the Leader:

Chongqing University Cancer Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

CZLS2024021-A

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

重庆大学附属肿瘤医院伦理委员会

Name of the ethic committee:

Ethics Committee of Cancer Hospital Affiliated to Chongqing University

伦理委员会批准日期:

Date of approved by ethic committee:

2024-01-25 00:00:00

伦理委员会联系人:

汤晓华

Contact Name of the ethic committee:

Xiao-Hua Tang

伦理委员会联系地址:

重庆市沙坪坝汉渝路181号

Contact Address of the ethic committee:

No.181, Hanyu Road, Shapingba District, Chongqing, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 23 6507 5696

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

重庆大学附属肿瘤医院麻醉科

Primary sponsor:

Department of Anesthesiology, Chongqing University Cancer Hospital

研究实施负责(组长)单位地址:

重庆市沙坪坝区汉渝路181号

Primary sponsor's address:

No.181, Hanyu road, Shapingba District, Chongqing

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

重庆市

市(区县):

Country:

China

Province:

Chongqing

City:

单位(医院):

重庆大学附属肿瘤医院

具体地址:

重庆市沙坪坝区汉渝路181号

Institution
hospital:

Chongqing University Cancer hospital

Address:

No.181, Hanyu road, Shapingba District, Chongqing

经费或物资来源:

Source(s) of funding:

None

研究疾病:

机器人辅助前列腺癌根治术  

Target disease:

robot-assisted radical prostatectomy

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

探索性研究/预试验 

Study phase:

0

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究主要目标是与传统固定PEEP通气模式比较,探讨以最小驱动压为指导滴定个体化最佳PEEP优化机器人辅助下前列腺癌根治术患者的呼吸力学,改善氧合,减少肺部并发症的可能性;同时观察在实施个体化PEEP时,患者在Trendelenburg体位下血流动力学及颅内压的变化。  

Objectives of Study:

This study aim to test the hypothesis that driving pressure-guided individualized PEEP would improve intraoperative respiratory mechanics, oxygenation, and postoperative pulmonary complications in nonobese individuals undergoing robot-assisted laparoscopic radical prostatectomy, and to investigate the effects of individualized PEEP on hemodynamics and intracranial pressure when patients are in a steep Trendelenburg position.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

① 4周内有上呼吸道或肺部感染的病史;② 严重心肺部疾患;③ 房颤患者;④ 心功能 ≥ III级;⑤ 神经肌肉功能障碍;⑥ 颅内压增高;⑦ 青光眼;⑧ 因术中大出血导致严重低血压或危及生命的并发症;⑨ 中转开腹者;⑩ 拒绝参与者。

Exclusion criteria:

① A history of upper respiratory tract or pulmonary infection within the previous 4 weeks, ② Patients with severe cardiopulmonary diseases; ③ Patients with atrial fibrillation; ④ NYHA ≥ III; ⑤ Neuromuscular dysfunction; ⑥ Intracranial hypertension; ⑦ Glaucoma; ⑧ Severe hypotension due to intra-operative hemorrhage or life-threatening complications; ⑨ Conversion to open approach; ⑩ Patients refused to participate in the clinical trial.

研究实施时间:

Study execute time:

From 2024-03-01 00:00:00 To 2025-08-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2024-03-01 00:00:00 To 2024-11-30 00:00:00

干预措施:

Interventions:

组别:

传统固定PEEP组

样本量:

21

Group:

Conventional fixed PEEP group

Sample size:

干预措施:

气管插管后,进行一次肺复张,随后将PEEP设置为5 cmH2O,整个机械通气期间维持固定PEEP进行通气。

干预措施代码:

Intervention:

After endotracheal intubation followed by a recruitment manoeuvre (RM), a positive end-expiratory pressure (PEEP) maintained at 5 cmH2O throughout the entire mechanical ventilation period.

Intervention code:

组别:

个体化PEEP组

样本量:

21

Group:

Individualized PEEP group

Sample size:

干预措施:

最小驱动压介导个体化PEEP:个体化PEEP组在第一次肺复张后开始PEEP滴定,从PEEP 20 cmH2O逐步以2 cmH2O向下递减至4 cmH2O,记录到最小驱动压对应的PEEP值记作PEEPIND。随即进行第二次肺复张,然后以PEEPIND1进行机械通气。建立气腹+Trendelenburg体位后,重复以上步骤完成第三次肺复张、PEEPIND滴定及第四次肺复张,随即以PEEPIND2进行机械通气,直至患者结束气腹并转为平卧位,再将PEEPIND2调至PEEPIND1进行机械通气到结束

干预措施代码:

Intervention:

Following endotracheal intubation, the initial recruitment manoeuvre followed by a decremental PEEP-titration trial will be performed. The minimum driving pressure will be recorded by decreasing PEEP stepwise by 2 cmH2O from 20 cmH2O to 4 cmH2O. Individualised PEEP (PEEPIND) is defined as a PEEP that produced the minimum driving pressure. A second recruitment manoeuvre will be performed at the end of the decremental PEEP trial and then PEEPIND1 will be applied. Subsequently, the third RM followed a decremental PEEP trial will be performed after achieving the pneumoperitoneum with the steep Trendelenburg position. A fourth RM will be performed at the end of the decremental PEEP trial.The patient will then be mechanically ventilated with PEEPIND2 until the pneumoperitoneum is desufflated and the patient is repositioned to a supine position. PEEPIND2 will then be adjusted to PEEPIND1 for mechanical ventilation until the end to prevent further lung hyperinflation.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

重庆市 

市(区县):

 

Country:

China

Province:

Chongqing

City:

单位(医院):

重庆大学附属肿瘤医院 

单位级别:

三甲 

Institution
hospital:

Chongqing University Cancer Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

氧合指数(PaO2/FiO2)

指标类型:

主要指标

Outcome:

Oxygenation Index (PaO2/FiO2)

Type:

Primary indicator

测量时间点:

测量方法:

动脉血气分析

Measure time point of outcome:

Measure method:

Arterial blood gas analysis

指标中文名:

气道峰压

指标类型:

次要指标

Outcome:

Peak airway pressure

Type:

Secondary indicator

测量时间点:

测量方法:

麻醉机自动采集

Measure time point of outcome:

Measure method:

automatic collected by anesthesia machine

指标中文名:

气道平台压

指标类型:

次要指标

Outcome:

plateau pressure

Type:

Secondary indicator

测量时间点:

测量方法:

麻醉机自动采集

Measure time point of outcome:

Measure method:

automatic collected by anesthesia machine

指标中文名:

呼气末正压

指标类型:

次要指标

Outcome:

end-expiratory positive pressure

Type:

Secondary indicator

测量时间点:

测量方法:

麻醉机自动采集

Measure time point of outcome:

Measure method:

automatic collected by anesthesia machine

指标中文名:

驱动压

指标类型:

次要指标

Outcome:

Driving pressure

Type:

Secondary indicator

测量时间点:

测量方法:

气道平台压— 呼气末正压

Measure time point of outcome:

Measure method:

plateau pressure minus PEEP

指标中文名:

肺顺应性

指标类型:

次要指标

Outcome:

Pulmonary compliance

Type:

Secondary indicator

测量时间点:

测量方法:

麻醉机自动采集

Measure time point of outcome:

Measure method:

automatic collected by anesthesia machine

指标中文名:

平均动脉压

指标类型:

次要指标

Outcome:

mean arterial pressure

Type:

Secondary indicator

测量时间点:

测量方法:

Mostcare 自动采集

Measure time point of outcome:

Measure method:

automatic collected by Mostcare

指标中文名:

每博量变异率

指标类型:

次要指标

Outcome:

stroke volume variation

Type:

Secondary indicator

测量时间点:

测量方法:

Mostcare 自动采集

Measure time point of outcome:

Measure method:

automatic collected by Mostcare

指标中文名:

心脏指数

指标类型:

次要指标

Outcome:

cardiac index

Type:

Secondary indicator

测量时间点:

测量方法:

Mostcare 自动采集

Measure time point of outcome:

Measure method:

automatic collected by Mostcare

指标中文名:

视神经鞘直径

指标类型:

次要指标

Outcome:

The diameter of optic nerve sheath

Type:

Secondary indicator

测量时间点:

测量方法:

超声测量

Measure time point of outcome:

Measure method:

measured by ultrasonography

指标中文名:

术后肺部并发症

指标类型:

次要指标

Outcome:

Post-operative pulmonary complications

Type:

Secondary indicator

测量时间点:

测量方法:

根据欧洲围手术期临床结果(EPCO)定义指南给出的PPCs详细诊断标准

Measure time point of outcome:

Measure method:

Detailed diagnostic criteria for PPCs are given according to the European Perioperative Clinical Outcomes (EPCO) Definitional Guidelines

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 99 years

性别:

男性

Gender:

Male

随机方法(请说明由何人用什么方法产生随机序列):

随机分配序列由未参与研究的麻醉医生在麻醉前使用计算机随机生成,按照入院顺序给患者分配随机序号。

Randomization Procedure (please state who generates the random number sequence and by what method):

Randomization will be done based on a computer-generated allocation sequence before induction of anaesthesia. Participants will be assigned random serial numbers in the order of admission by an anaesthesiologist not involved in the study.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

病人、实施超声人员、复苏室人员、术后随访人员及数据统计人员不知道分组情况。

Blinding:

The patients, the ultrasound implementor, the staff in the PACU, the post-operative follow-up investigators and the staff analysing the data will be unaware of the allocation.

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

试验完成后6个月内以论文形式公开; ResMan, http://www.medresman.org.cn.

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Within six months after the trial complete by paper; ResMan, http://www.medresman.org.cn.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

1.临床数据采集采用病历记录表(Case Record Form,CRF); 2.数据管理采用电子采集和管理系统(Electronic Data Capture,EDC)

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

1. Clinical data collection uses Case Record Form (CRF); 2. Data collection and management system with Electronic Data Capture(EDC)

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2024-02-28 16:40:07