Effect of Vasopressin vs Norepinephrine on Pulmonary Oxygenation and Lung Mechanics in Patients With Hypertension Therapy During One-lung Ventilation : Preliminary Study

Last updated: May 3, 2021
Sponsor: Yonsei University
Overall Status: Active - Recruiting

Phase

N/A

Condition

Circulation Disorders

Stress

Williams Syndrome

Treatment

N/A

Clinical Study ID

NCT04170751
4-2019-0696
  • Ages 40-80
  • All Genders

Study Summary

Hypotension during anesthesia often occurs because reduced systemic vascular resistance and blocked sympathetic nervous system by anesthetic drugs. In patients who are taking hypertension medication, blood pressure drops are exaggerated by inadequate compensation mechanism due to decrease of blood vessel elasticity and desensitization of baroreceptors. In one-lung ventilation (OLV) during thoracic surgery, persistent perfusion of non-ventilatory lungs can lead to increased intra-pulmonary shunt and hypoxemia. As a compensatory mechanism, the gravitational effect and hypoxic pulmonary vasoconstriction occur. Among these, hypoxic pulmonary vasoconstriction is associated with pulmonary vascular resistance. Norepinephrine and vasopressin, which are commonly used in patients with hypotension, affect systemic and pulmonary vascular resistance. However, no studies have been done on lung oxygenation and pulmonary mechanics of these vasoactive drugs in patients undergoing surgery on one lung. Therefore, the purpose of this study is to investigate the effects of vasoactive drugs, norepinephrine and vasopressin, in patients with hypertension.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Adult patients aged 40-80 years who are planning to have thoracoscopic singlelobectomy with unilateral lung ventilation during surgery.
  2. Patients taking hypertension drug CCB(calcium channel blocker), ARB(angiotensin IIreceptor blocker), ACEi(ACE inhibitor, angiotensin converting enzyme inhibitor) atleast 4 weeks.
  3. American Society of Anesthesiologists (ASA) classification 2~3

Exclusion

Exclusion Criteria:

  1. patients with heart failure (NYHA class III~IV)
  2. patients who are having moderate obstructive lung disease or restrictive lung disease
  3. Low DLCO (< 75%)
  4. patients with pulmonary hypertension (mean PAP>25mmHg)
  5. patients with liver disease (AST level ≥100 IU/mL or ALT ≥ level 50 IU/L) or kidneydisease (Creatine level ≥ 1.5 mg/dL)
  6. body mass index (BMI) > 30 kg/m2
  7. patients who cannot read explanation and consent form
  8. patients who are pregnant

Study Design

Total Participants: 40
Study Start date:
November 18, 2019
Estimated Completion Date:
September 30, 2021

Connect with a study center

  • Department of Anaesthesiology and Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine

    Seoul, 03722
    Korea, Republic of

    Active - Recruiting

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