• J. Cardiothorac. Vasc. Anesth. · Sep 2019

    Randomized Controlled Trial Multicenter Study

    Rationale and Study Design for an Individualized Perioperative Open Lung Ventilatory Strategy in Patients on One-Lung Ventilation (iPROVE-OLV).

    • Albert Carramiñana, Carlos Ferrando, M Carmen Unzueta, Ricard Navarro, Fernando Suárez-Sipmann, Gerardo Tusman, Ignacio Garutti, Marina Soro, Natividad Pozo, Julián Librero, Lucía Gallego, Fernando Ramasco, José M Rabanal, Aurelio Rodriguez, José Sastre, Jesús Martinez, Silvia Coves, Pablo García, Pilar Aguirre-Puig, José Yepes, Aitana Lluch, Daniel López-Herrera, Sonsoles Leal, Marc Vives, Soledad Bellas, Tania Socorro, Ramón Trespalacios, Claudia J Salazar, Ana Mugarra, Gilda Cinnella, Savino Spadaro, Emmanuel Futier, Leopoldo Ferrer, María Cabrera, Helder Ribeiro, Catarina Celestino, Evrim Kucur, Oriol Cervantes, Diego Morocho, Dalia Delphy, Carolina Ramos, Jesús Villar, Javier Belda, and iPROVE-OLV Network.
    • Department of Anesthesia and Critical Care, Hospital Clínic i Provincial, Barcelona, Spain.
    • J. Cardiothorac. Vasc. Anesth. 2019 Sep 1; 33 (9): 2492-2502.

    ObjectiveThe aim of this clinical trial is to examine whether it is possible to reduce postoperative complications using an individualized perioperative ventilatory strategy versus using a standard lung-protective ventilation strategy in patients scheduled for thoracic surgery requiring one-lung ventilation.DesignInternational, multicenter, prospective, randomized controlled clinical trial.SettingA network of university hospitals.ParticipantsThe study comprises 1,380 patients scheduled for thoracic surgery.InterventionsThe individualized group will receive intraoperative recruitment maneuvers followed by individualized positive end-expiratory pressure (open lung approach) during the intraoperative period plus postoperative ventilatory support with high-flow nasal cannula, whereas the control group will be managed with conventional lung-protective ventilation.Measurements And Main ResultsIndividual and total number of postoperative complications, including atelectasis, pneumothorax, pleural effusion, pneumonia, acute lung injury; unplanned readmission and reintubation; length of stay and death in the critical care unit and in the hospital will be analyzed for both groups. The authors hypothesize that the intraoperative application of an open lung approach followed by an individual indication of high-flow nasal cannula in the postoperative period will reduce pulmonary complications and length of hospital stay in high-risk surgical patients.Copyright © 2019. Published by Elsevier Inc.

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