Effects of different driving pressures on venous return during regular frequency jet ventilation: a randomized controlled study

注册号:

Registration number:

ChiCTR2600124980 

最近更新日期:

Date of Last Refreshed on:

2026-05-20 09:36:51 

注册时间:

Date of Registration:

2026-05-20 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

常频喷射通气不同驱动压力对静脉回流影响的随机对照研究

Public title:

Effects of different driving pressures on venous return during regular frequency jet ventilation: a randomized controlled study

注册题目简写:

English Acronym:

研究课题的正式科学名称:

常频喷射通气不同驱动压力对静脉回流影响的随机对照研究

Scientific title:

Effects of different driving pressures on venous return during regular frequency jet ventilation: a randomized controlled study

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:

杨明媛 

研究负责人:

杨明媛 

Applicant:

Mingyuan Yang 

Study leader:

Mingyuan Yang 

申请注册联系人电话:

Applicant telephone:

+86 10 87935412

研究负责人电话:

Study leader's telephone:

+86 10 87935413

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:

elivina87@126.com

研究负责人电子邮件:

Study leader's E-mail:

elivina87@126.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:

北京市朝阳区西坝河南里29号

研究负责人通讯地址:

北京市朝阳区西坝河南里29号

Applicant address:

No. 29, Xibahenali, Chaoyang District, Beijing

Study leader's address:

No 29 Xiba Henanli, ChaoyangDistrict, Beijing 100028, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

应急总医院

Applicant's institution:

Emergency general hospital

研究负责人所在单位:

应急总医院

Affiliation of the Leader:

Emergency General Hospital

是否获伦理委员会批准:

是/Yes

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

KX26-2

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:

应急总医院伦理委员会

Name of the ethic committee:

China Emergency General Hospital Ethics Committee

伦理委员会批准日期:

Date of approved by ethic committee:

2026-04-03 00:00:00

伦理委员会联系人:

聂翠芳

Contact Name of the ethic committee:

Nie Cuifang

伦理委员会联系地址:

北京市朝阳区西坝河南里29号

Contact Address of the ethic committee:

No 29 Xiba Henanli, ChaoyangDistrict, Beijing 100028, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 10 87935595

伦理委员会联系人邮箱:

Contact email of the ethic committee:

niecuifang4208@126.com

研究实施负责(组长)单位:

应急总医院

Primary sponsor:

Emergency General Hospital

研究实施负责(组长)单位地址:

北京市朝阳区西坝河南里29号

Primary sponsor's address:

No 29 Xiba Henanli, ChaoyangDistrict, Beijing 100028, 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):

北京市

市(区县):

Country:

China

Province:

Beijing

City:

单位(医院):

应急总医院

具体地址:

北京市朝阳区西坝河南里29号

Institution
hospital:

Emergency General Hospital

Address:

No 29 Xiba Henanli, ChaoyangDistrict, Beijing 100028, China

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Self financing

Target disease:

None

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

系统比较分析在常频喷射通气模式下不同驱动压力水平对下腔静脉变异幅度的影响,探索驱动压力与CTI之间的量效关系,判断是否存在压力阈值或非线性变化特征。从胸腔压力—静脉回流耦合的角度审视喷射通气参数选择问题,实现研究视角的根本转变。  

Objectives of Study:

The system comparatively analyzed the influence of different driving pressure levels under the constant frequency jet ventilation mode on the variation amplitude of the inferior vena cava, explored the dose-effect relationship between driving pressure and CTI, and determined whether there was a pressure threshold or nonlinear change characteristics. It reviewed the issue of jet ventilation parameter selection from the perspective of the coupling between thoracic pressure and venous return, achieving a fundamental shift in the research perspective.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

1.年龄18–60岁,性别不限;
2.ASA 分级 I–III 级;
3.拟在全身麻醉下行经硬质气管镜纵隔或肺门淋巴结穿刺活检;
4.术前影像学检查(胸部 CT)提示气管及主支气管腔通畅,无明显占位性病变或重度狭窄(管腔狭窄 <30%);
5.预计手术时间≥30分钟,喷射通气维持时间≥20分钟,可完成设定的各时间点测量;
6.术前床旁或预评估超声可清晰显示下腔静脉(IVC)图像,能够完成 CTI 测量;
7.患者或其法定代理人已签署麻醉知情同意书及研究知情同意书。

Inclusion criteria

1. Age: 18 to 60 years old, gender unrestricted. 2. ASA classification I–III; 3. It is planned to perform mediastinal or hilar lymph node puncture biopsy under general anesthesia via rigid bronchoscopy. 4. Preoperative imaging studies (chest CT) indicated that the trachea and main bronchi were unobstructed, with no significant space-occupying lesions or severe stenosis (lumen stenosis < 30%). 5. If the estimated operation time is >= 30 minutes and the duration of jet ventilation is >= 20 minutes, the measurements at each set time point can be completed. 6. Preoperative bedside or pre-assessment ultrasound can clearly display the image of the inferior vena cava (IVC) and complete the measurement of CTI. 7. The patient or his/her legal representative has signed the informed consent form for anesthesia and the informed consent form for the study.

排除标准:

1.存在明显主气道占位或严重狭窄(气管或主支气管狭窄>=30%),需依赖高压喷射或特殊通气策略维持通气者;
2.合并严重肺部基础疾病,可能显著影响喷射通气效果或胸腔压力传递,如:重度 COPD、重度肺气肿或肺大疱、活动性严重肺部感染、肺纤维化和肺间质性病变、呼吸衰竭等;
3.存在显著影响下腔静脉解剖或血流动力学解读的心血管疾病,包括但不限于:中-重度右心衰竭、明显肺动脉高压、重度三尖瓣返流、既往下腔静脉滤器植入或下腔静脉手术史;
4.术前存在明显容量干预因素,可能影响基线 CTI 解读:术前6小时内快速或大量补液(>10 mL/kg);使用较大剂量血管活性药物;
5.BMI≥35 kg/m² 或其他原因导致下腔静脉超声成像困难,无法获得可靠 CTI 数据;
6.术中因病情变化需临时改变通气模式,无法完成既定研究流程者;
7.研究过程中出现严重不良事件(如持续低氧、严重低血压、气压伤等),研究者认为继续研究可能危及患者安全者。

Exclusion criteria:

1. Those with obvious main airway occupation or severe stenosis (tracheal or main bronchial stenosis >= 30%), who need to rely on high-pressure jet or special ventilation strategies to maintain ventilation; 2. Severe underlying pulmonary diseases that may significantly affect the effect of jet ventilation or the transmission of intrathoracic pressure, such as: severe COPD, severe emphysema or pulmonary bullae, active severe pulmonary infection, pulmonary fibrosis and interstitial lung disease, respiratory failure, etc. 3. Cardiovascular diseases that have a significant impact on the anatomy or hemodynamic interpretation of the inferior vena cava, including but not limited to: moderate to severe right heart failure, significant pulmonary hypertension, severe tricuspid regurgitation, previous history of inferior vena cava filter implantation or inferior vena cava surgery. 4. There were obvious volume intervention factors before the operation that might affect the interpretation of the baseline CTI: rapid or large-volume fluid infusion (>10 mL/kg) within 6 hours before the operation; use of large doses of vasoactive drugs; 5. BMI >= 35 kg/m^2 or other reasons causing difficulty in ultrasound imaging of the inferior vena cava, and reliable CTI data cannot be obtained. 6. Those who need to temporarily change the ventilation mode due to changes in the condition during the operation and thus cannot complete the pre-determined research process; 7. In the course of the research, if serious adverse events occur (such as persistent hypoxia, severe hypotension, barotrauma, etc.) and the researcher deems that continuing the research may endanger the patient's safety.

研究实施时间:

Study execute time:

From 2026-06-01 00:00:00 To 2027-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-06-01 00:00:00 To 2027-12-31 00:00:00  

干预措施:

Interventions:

组别:

高压组

样本量:

30

Group:

High pressure group

Sample size:

干预措施:

驱动压力 1.1 bar

干预措施代码:

Intervention:

Drving presuure 1.1 bar

Intervention code:

组别:

低压组

样本量:

30

Group:

Low pressure group

Sample size:

干预措施:

驱动压力 0.7 bar

干预措施代码:

Intervention:

Drving presuure 0.7 bar

Intervention code:

组别:

中压组

样本量:

30

Group:

Medium pressure group

Sample size:

干预措施:

驱动压力 0.9 bar

干预措施代码:

Intervention:

Drving presuure 0.9 bar

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

北京市 

市(区县):

 

Country:

China 

Province:

Beijing 

City:

 

单位(医院):

应急总医院 

单位级别:

三级医院 

Institution
hospital:

Emergency General Hospital

Level of the institution:

Tertiary

测量指标:

Outcomes:

指标中文名:

术中不良事件发生率

指标类型:

次要指标

Outcome:

The incidence of intraoperative adverse events

Type:

Secondary indicator

测量时间点:

围术期

测量方法:

Measure time point of outcome:

perioperative period

Measure method:

指标中文名:

动脉血气指标

指标类型:

次要指标

Outcome:

Arterial blood gas indicators

Type:

Secondary indicator

测量时间点:

T3(开放通气稳定期)

测量方法:

动脉血气机

Measure time point of outcome:

T3 (Open ventilation stable period)

Measure method:

Arterial blood gas exchange

指标中文名:

T3(开放通气稳定期)下腔静脉塌陷指数

指标类型:

主要指标

Outcome:

Inferior vena cava collapse index at T3

Type:

Primary indicator

测量时间点:

T3(开放通气稳定期)

测量方法:

超声测量

Measure time point of outcome:

T3 (Open ventilation stable period)

Measure method:

ultrasonic measurement

指标中文名:

血流动力学指标

指标类型:

次要指标

Outcome:

Hemodynamic indicators

Type:

Secondary indicator

测量时间点:

T0(自主呼吸)、T1(闭合通气期)、T2(开放通气初期)、T3(开放通气稳定期)、T4(恢复期)

测量方法:

记录监护仪数据

Measure time point of outcome:

T0, T1, T2 ,T3,T4

Measure method:

Record the data from the monitor.

指标中文名:

其他时间点下腔静脉塌陷指数

指标类型:

次要指标

Outcome:

The inferior vena cava collapse index at other time points

Type:

Secondary indicator

测量时间点:

T0(自主呼吸)、T1(闭合通气期)、T2(开放通气初期)、T4(恢复期)

测量方法:

超声测量

Measure time point of outcome:

T0, T1, T2 ,T4

Measure method:

ultrasonic measurement

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

动脉血

组织:

Sample Name:

arterial blood

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 60 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):

由专门的科研人员采用计算机生成随机序列(1:1:1),使用区组随机(区组大小6或9)并按 ASA 分级(I–II vs III)进行分层,以平衡基础风险。随机分配结果置于不透明密封信封,由非评估人员在进入喷射通气阶段前开启。

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

Random sequences (1:1:1) were generated by dedicated researchers using a computer. Stratification was performed by block randomization (block size 6 or 9) and ASA classification (I–II vs III) to balance the baseline risk. The randomization results were placed in opaque sealed envelopes and opened by non-assessors before entering the jet ventilation phase.

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:

单盲,对评估者设盲

Blinding:

Single blind study with blinded-evaluators

是否共享原始数据:

IPD sharing

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):

本研究拟共享去标识化后的个体水平数据及数据字典,不包含姓名、住院号、联系方式等可识别个人身份的信息。具有合理科研目的的研究者可通过电子邮件联系通信作者/研究负责人,提交研究方案和数据使用计划。经研究团队审核并签署数据使用协议后,以加密文件方式提供去标识化数据。数据共享范围将符合伦理委员会批准内容。

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

De-identified individual participant data and a data dictionary will be available. Researchers with a reasonable scientific purpose may contact the corresponding investigator by email and submit a research proposal and data-use plan. After approval by the study team and completion of a data-use agreement, de-identified data will be provided in an encrypted file. No personally identifiable information will be shared, and data sharing will be conducted within the scope approved by the ethics committee.

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:

CRF 表

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

CRF

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2026-05-20 09:36:26