Clinical Effects of Intraoperative Heat and Moisture Exchange Systems During Thoracic Surgery: A Prospective Observational Cohort Study
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Active Heated Humidification, Heat and Moisture Exchanger.
- Кому может быть актуально
- Состояния в реестре: Video Assisted Thoracic Surgery (VATS), Postoperative Complications, Pulmonary Complications in Surgical Patients, Humidification. Базовые параметры: 18 лет — 75 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Turkey (Türkiye)
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Clinical Effects of Active Versus Passive Intraoperative Respiratory Gas Humidification During Video-Assisted Thoracoscopic Surgery: A Prospective Single-Center Observational Cohort Study
Обзор
General anesthesia with endotracheal intubation bypasses the physiological warming and humidification functions of the upper airway, allowing cold and dry gases to reach the lower respiratory tract. This may impair mucociliary clearance, increase secretion viscosity, promote atelectasis, and contribute to postoperative pulmonary complications (PPCs). Patients undergoing thoracic surgery, particularly those requiring one-lung ventilation (OLV), are at increased risk for PPCs because of altered ventilation-perfusion matching, reduced functional residual capacity, and impaired secretion clearance. Although respiratory gas humidification is routinely used during anesthesia, evidence regarding the comparative clinical effects of active heated humidification (AHH) and passive heat and moisture exchangers (HMEs) during thoracic surgery remains limited. This prospective observational cohort study aims to evaluate the association between intraoperative respiratory gas humidification methods and postoperative pulmonary complications and perioperative clinical outcomes in adult patients undergoing elective video-assisted thoracoscopic surgery (VATS).
Подробное описание
The physiological conditioning of inspired gases is bypassed during general anesthesia with endotracheal intubation. Delivery of inadequately heated and humidified gases to the lower respiratory tract may impair mucociliary function, increase secretion viscosity, reduce airway patency, and promote postoperative pulmonary complications.
Patients undergoing video-assisted thoracoscopic surgery (VATS) frequently require one-lung ventilation, which further increases susceptibility to pulmonary complications through ventilation-perfusion mismatch, impaired secretion clearance, and atelectasis formation.
Two principal approaches are used for intraoperative respiratory gas conditioning:
Passive heat and moisture exchangers (HMEs) Active heated humidification systems (AHHs) Although HMEs are widely used because of their simplicity, they may provide insufficient humidification during prolonged procedures, high minute ventilation, or one-lung ventilation. Active heated humidifiers deliver gases closer to physiological conditions (approximately 37°C and 100% relative humidity), potentially reducing secretion viscosity and improving airway patency.
Most existing studies evaluating respiratory gas humidification have focused on intensive care patients receiving prolonged mechanical ventilation. Evidence regarding thoracic surgical patients remains limited, particularly during one-lung ventilation.
This prospective, single-center observational cohort study will compare perioperative outcomes among patients managed with active or passive humidification according to routine anesthetic practice. No intervention or randomization will be performed.
Вмешательства
- Устройство Active Heated Humidification
An active heated humidification system integrated into the anesthesia breathing circuit is used during intraoperative mechanical ventilation to warm and humidify inspired respiratory gases. Device selection and clinical management are determined solely by the attending anesthesiologist according to institutional routine practice. No study-specific intervention or modification of patient care is performed. - Устройство Heat and Moisture Exchanger
A passive heat and moisture exchanger filter is incorporated into the anesthesia breathing circuit during intraoperative mechanical ventilation to conserve heat and moisture from exhaled gases. Device selection is based on routine clinical practice, and no intervention is assigned by the study protocol.
Первичные конечные точки
- Incidence of Postoperative Pulmonary Complications [Срок оценки: From completion of surgery through postoperative Day 7.]
Вторичные конечные точки (11)
- Oxygenation (PaO₂/FiO₂ Ratio) [Срок оценки: Measured during one-lung ventilation and at the end of surgery.]
- Frequency of Endotracheal Suctioning [Срок оценки: From induction of anesthesia until completion of surgery.]
- Airway Secretion Viscosity Score [Срок оценки: During one-lung ventilation, at the end of one-lung ventilation, and within 24 hours after extubation.]
- Incidence of Intraoperative Hypothermia [Срок оценки: From induction of anesthesia until completion of surgery.]
- Incidence of Postoperative Hypothermia [Срок оценки: Within the first 24 hours after surgery.]
- Postoperative Oxygen Therapy Requirement [Срок оценки: Within the first 72 hours after surgery.]
- Requirement for Non-invasive Ventilation [Срок оценки: Within the first 72 hours after surgery.]
- Intensive Care Unit Length of Stay [Срок оценки: From ICU admission until ICU discharge, up to postoperative Day 30.]
- Hospital Length of Stay [Срок оценки: From surgery until hospital discharge, up to postoperative Day 30.]
- Bronchodilator Therapy Requirement [Срок оценки: Within 7 days after surgery.]
- C-Reactive Protein (CRP) [Срок оценки: Postoperative Day 7.]
Критерии участия
Критерии включения
- Patients aged 18 to 75 years
- Elective video-assisted thoracoscopic surgery (VATS)
- Lung resection requiring general anesthesia
- Planned one-lung ventilation
- Written informed consent
Критерии исключения
- Emergency surgery
- Pregnancy
- Preoperative mechanical ventilation
- Previous enrollment
- Refusal to participate
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Модель наблюдения
- Когортное
Центры проведения
Turkey (Türkiye) · 1 центр
- Marmara University — Istanbul
Идентификаторы
NCT: NCT07729319 · 09.2026.26-0220