利用电阻抗断层成像技术对老年患者肺切除术实施个体化通气设定的前瞻性随机对照研究

注册号:

Registration number:

ChiCTR1800019359 

最近更新日期:

Date of Last Refreshed on:

2018-11-07 20:21:59 

注册时间:

Date of Registration:

2018-11-07 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

利用电阻抗断层成像技术对老年患者肺切除术实施个体化通气设定的前瞻性随机对照研究

Public title:

Individualized ventilation setting by electrical impedance tomography in elderly patients undergoing lung resection: a randomized controlled trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

利用电阻抗断层成像技术对老年患者肺切除术实施个体化通气设定的前瞻性随机对照研究

Scientific title:

Individualized ventilation setting by electrical impedance tomography in elderly patients undergoing lung resection: a randomized controlled trial

研究课题代号(代码):

Study subject ID:

上海市科学技术委员会项目(16411967600)

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:

吴镜湘 

研究负责人:

徐美英 

Applicant:

Jingxiang Wu 

Study leader:

Meiying Xu 

申请注册联系人电话:

Applicant telephone:

+86 18930857186

研究负责人电话:

Study leader's
telephone:

+86 13601627254

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:

wjx1132@163.com

研究负责人电子邮件:

Study leader's E-mail:

xumeiyingxk@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:

上海市淮海西路241号,胸科医院麻醉科

研究负责人通讯地址:

上海市淮海西路241号,胸科医院麻醉科

Applicant address:

241 West Huaihai Road, Shanghai, China

Study leader's address:

241 West Huaihai Road, Shanghai, China

申请注册联系人邮政编码:

Applicant postcode:

200030

研究负责人邮政编码:

Study leader's postcode:

200030

申请人所在单位:

上海交通大学附属胸科医院

Applicant's institution:

Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiaotong University

研究负责人所在单位:

上海交通大学附属胸科医院

Affiliation of the Leader:

Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiaotong University

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:

KS1866

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:

上海市胸科医院伦理委员会

Name of the ethic committee:

Ethics Committee of Shanghai Chest Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2018-09-11 00:00:00

伦理委员会联系人:

Contact Name of the ethic committee:

伦理委员会联系地址:

Contact Address of the ethic committee:

伦理委员会联系人电话:

Contact phone of the ethic committee:

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:

上海交通大学附属胸科医院

Primary sponsor:

Shanghai Chest Hospital, Shanghai Jiaotong University

研究实施负责(组长)单位地址:

上海市淮海西路241号

Primary sponsor's address:

241 West Huaihai Road, Shanghai, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

上海交通大学附属胸科医院

具体地址:

上海市淮海西路241号

Institution
hospital:

Shanghai Chest Hospital, Shanghai Jiaotong University

Address:

241 West Huaihai Road, Shanghai, China

经费或物资来源:

上海市科学技术委员会项目(16411967600)

Source(s) of funding:

Shanghai science and technology committee (16411967600)

研究疾病:

胸科手术  

Target disease:

Thoracic surgery

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:

治疗新技术临床试验 

Study phase:

New Treatment Measure Clinical Study

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

对比临床固定PEEP通气管理策略,观察患者术后肺部并发症有无差异  

Objectives of Study:

To investigated whether optimizing end-expiratory pressure(PEEP) by Electrical Impedance Tomography could reduce the postoperative pulmonary complications in in elderly patients undergoing lung resection

药物成份或治疗方案详述:

个体化PEEP滴定采用肺阻抗断层成像法(PEEPind),即 在肺复张后从15cmHO开始按从高到低顺序每分钟减少PEEP压力2cmHO,然后用定制软件滴定,肺不张曲线和肺过度膨胀曲线交叉点设为最佳PEEPind; 对照组:双肺通气时潮气量8ml/kg; 单肺通气时潮气量6mL/Kg;PEEP=5 cmH2O PEEPind组:双肺通气时潮气量8ml/kg;单肺通气时潮气量6mL/Kg; PEEP=PEEPind  

Description for medicine or protocol of treatment in detail:

individualized PEEP titrated using electrical impedance tomography (PEEPind) The PEEPIND arm received an RM followed by a decremental PEEP titration, during which PEEP was set to 15cm H2O and decreased stepwise by 2 cm H2O every 1 min. After the PEEP titration, PEEPind was calculated off-line using customized software. The PEEP corresponding to the cross of revesible atelectasis curve and lung overdistension curve was identified as PEEPind. DLV Vt=8ml/kg; OLV Vt=6mL/Kg; PEEP was maintained 5 cmH2O in control group and PEEPind in PEEPind group throughout OLV mechanical ventilation  

纳入标准:

Inclusion criteria

排除标准:

1. 术前肺功能差不能耐受单肺通气的患者
2. 术前存在支气管扩张、呼吸道感染,持续咳嗽咳痰、肺内分泌物多的
3. 任何不适用EIT测量的状况(起搏器,自动埋藏式除颤器,植入泵)
4. 术前血流动力学不稳定
5. 预计PEEP滴定不能耐受者

Exclusion criteria:

1. Patients with poor lung function who can not tolerate single lung ventilation before operation;
2. Preoperative bronchiectasis, respiratory tract infection, persistent cough and sputum, more secretions in the lungs;
3. Any condition not applicable to eit measurements (pacemakers, automatic implantable defibrillators, implantable pumps);
4. Preoperative hemodynamic instability;
5. Estimated peep titration intolerable.

研究实施时间:

Study execute time:

From 2018-11-07 00:00:00 To 2019-06-22 00:00:00  

征募观察对象时间:

Recruiting time:

From 2018-11-07 00:00:00 To 2019-06-22 00:00:00

干预措施:

Interventions:

组别:

对照组

样本量:

200

Group:

Group 1

Sample size:

干预措施:

双肺通气时潮气量8ml/kg; 单肺通气时潮气量6mL/Kg;PEEP=5 cmH2O

干预措施代码:

Intervention:

DLV Vt=8ml/kg; OLV Vt=6mL/Kg; PEEP=5 cmH2O

Intervention code:

组别:

PEEPind group

样本量:

200

Group:

Group 2

Sample size:

干预措施:

双肺通气时潮气量8ml/kg;单肺通气时潮气量6mL/Kg; PEEP=PEEPind

干预措施代码:

Intervention:

DLV Vt=8ml/kg; OLV Vt=6mL/Kg; PEEP=PEEPind

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海交通大学附属胸科医院 

单位级别:

三甲医院 

Institution
hospital:

Shanghai Chest Hospital, Shanghai Jiaotong University

Level of the institution:

Tertiary A Hospital

测量指标:

Outcomes:

指标中文名:

肺部并发症

指标类型:

主要指标

Outcome:

lung complications

Type:

Primary indicator

测量时间点:

术后住院期间

测量方法:

量表

Measure time point of outcome:

Postoperative hospitalization

Measure method:

rating scales

指标中文名:

氧合指数

指标类型:

次要指标

Outcome:

oxygenation index

Type:

Secondary indicator

测量时间点:

测量方法:

血气分析

Measure time point of outcome:

Measure method:

blood gas

指标中文名:

呼吸力学

指标类型:

次要指标

Outcome:

respiratory mechanics

Type:

Secondary indicator

测量时间点:

测量方法:

呼吸机

Measure time point of outcome:

Measure method:

ventilator

指标中文名:

住院天数

指标类型:

次要指标

Outcome:

hospital day

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

气道黏膜损伤标志物

指标类型:

次要指标

Outcome:

Airway mucosal injury markers

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

桡动脉

Sample Name:

blood

Tissue:

radial artery

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

血液

组织:

颈内静脉

Sample Name:

blood

Tissue:

jugular vein

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:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 65 years
最大 Max age 85 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

患者按1:1比例随机入组。随机序列由不参与本研究的工作人员用计算机生成。

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

Subjects will be randomized at a 1:1 ratio using simple randomization. The randomization sequence will be generated by a staff not otherwise involved in the current study.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

随访者评价量表时不知道分组,麻醉医师术中分组,但不知道随访结果

Blinding:

Participants are blinded to group assignment. Anesthesiologist will be aware of the group assignment in each case. The research scientist who analyzes the data will be blinded

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):

2020年1月 Resman 临床试验管理平台

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

January 2020 Resman http://www.medresman.org/

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:

Word,Excel,SPSS 以及上海市胸科医院电子病例

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

Word, Excel, SPSS and electric record of Shanghai Chest Hospital

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:

 2018-11-07 20:21:59