Publicaciones científicas

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

01-sep-2019 | Revista: Journal of Cardiothoracic and Vascular Anesthesia

Albert Carramiñana  1 , Carlos Ferrando  2 , M Carmen Unzueta  3 , Ricard Navarro  1 , Fernando Suárez-Sipmann  4 , Gerardo Tusman  5 , Ignacio Garutti  6 , Marina Soro  7 , Natividad Pozo  8 , Julián Librero  9 , Lucía Gallego  10 , Fernando Ramasco  11 , José M Rabanal  12 , Aurelio Rodriguez  13 , José Sastre  14 , Jesús Martinez  15 , Silvia Coves  16 , Pablo García  17 , Pilar Aguirre-Puig  18 , José Yepes  19 , Aitana Lluch  20 , Daniel López-Herrera  21 , Sonsoles Leal  22 , Marc Vives  23 , Soledad Bellas  24 , Tania Socorro  25 , Ramón Trespalacios  26 , Claudia J Salazar  27 , Ana Mugarra  7 , Gilda Cinnella  28 , Savino Spadaro  29 , Emmanuel Futier  30 , Leopoldo Ferrer  31 , María Cabrera  32 , Helder Ribeiro  33 , Catarina Celestino  34 , Evrim Kucur  35 , Oriol Cervantes  36 , Diego Morocho  37 , Dalia Delphy  38 , Carolina Ramos  39 , Jesús Villar  40 , Javier Belda  7 ; iPROVE-OLV Network


Objective: The 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.

Design: International, multicenter, prospective, randomized controlled clinical trial.

Setting: A network of university hospitals.

Participants: The study comprises 1,380 patients scheduled for thoracic surgery.

Interventions: The 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 results: Individual 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.

CITA DEL ARTÍCULO  J Cardiothorac Vasc Anesth. 2019 Sep;33(9):2492-2502. doi: 10.1053/j.jvca.2019.01.056.  Epub 2019 Feb 8.