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氙气对 Stanford A 型急性主动脉夹层手术成年患者术后氧损伤的保护作用:一项前瞻性随机对照临床试验的研究方案

Protection of xenon against postoperative oxygen impairment in adults undergoing Stanford Type-A acute aortic dissection surgery: Study protocol for a prospective, randomized controlled clinical trial.

作者信息

Jin Mu, Cheng Yi, Yang Yanwei, Pan Xudong, Lu Jiakai, Cheng Weiping

机构信息

Department of Anesthesiology Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.

出版信息

Medicine (Baltimore). 2017 Aug;96(34):e7857. doi: 10.1097/MD.0000000000007857.

Abstract

OBJECTIVES

The available evidence shows that hypoxemia after Stanford Type-A acute aortic dissection (AAD) surgery is a frequent cause of several adverse consequences. The pathogenesis of postoperative hypoxemia after AAD surgery is complex, and ischemia/reperfusion and inflammation are likely to be underlying risk factors. Xenon, recognized as an ideal anesthetic and anti-inflammatory treatment, might be a possible treatment for these adverse effects.

METHODS/DESIGN: The trial is a prospective, double-blind, 4-group, parallel, randomized controlled, a signal-center clinical trial. We will recruit 160 adult patients undergoing Stanford type-A AAD surgery. Patients will be allocated a study number and will be randomized on a 1:1:1:1 basis to receive 1 of the 3 treatment options (pulmonary inflated with 50% xenon, 75% xenon, or 100% xenon) or no treatment (control group, pulmonary inflated with 50% nitrogen). The aims of this study are to clarify the lung protection capability of xenon and its possible mechanisms in patients undergoing the Stanford type-A AAD surgery.

DISCUSSION

This trial uses an innovative design to account for the xenon effects of postoperative oxygen impairment, and it also delineates the mechanism for any benefit from xenon. The investigational xenon group is considered a treatment intervention, as it includes 3 groups of pulmonary static inflation with 50%, 75%, and 100% xenon. It is suggested that future trials might define an appropriate concentration of xenon for the best practice intervention.

摘要

目的

现有证据表明,斯坦福A型急性主动脉夹层(AAD)手术后的低氧血症是多种不良后果的常见原因。AAD手术后低氧血症的发病机制复杂,缺血/再灌注和炎症可能是潜在危险因素。氙气被认为是一种理想的麻醉和抗炎治疗药物,可能是治疗这些不良反应的一种方法。

方法/设计:该试验是一项前瞻性、双盲、4组、平行、随机对照的单中心临床试验。我们将招募160例接受斯坦福A型AAD手术的成年患者。患者将被分配一个研究编号,并将按1:1:1:1的比例随机接受3种治疗方案之一(肺内充入50%氙气、75%氙气或100%氙气)或不接受治疗(对照组,肺内充入50%氮气)。本研究的目的是阐明氙气对接受斯坦福A型AAD手术患者的肺保护能力及其可能机制。

讨论

本试验采用创新设计来解释氙气对术后氧损伤的影响,并阐明氙气产生任何益处的机制。研究中的氙气组被视为一种治疗干预措施,因为它包括3组肺静态充入50%、75%和100%氙气的情况。建议未来的试验可能会确定最佳实践干预中氙气的合适浓度。

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