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Individualized Inspired Oxygen Fraction Titration During Lung Surgery (iOXY-LUNG) (iOXY-LUNG)

4. november 2026 opdateret af: Juan Wei, Shanghai Pulmonary Hospital, Shanghai, China

Individualized Inspired Oxygen Titration Versus Pure Oxygen During Lung Surgery (iOXY-LUNG): a Randomized Clinical Trial

The goal of this clinical trial is to determine whether individualized oxygen adjustment during lung surgery lowers the risk of major complications. The study will include adults undergoing planned surgery on one lung that requires more than one hour of one-lung ventilation. One-lung ventilation means that only one lung is ventilated during part of the operation.

The main question is:

Does individualized oxygen adjustment, compared with continuous 100% oxygen, lower the risk of death or major complications within 30 days after surgery?

Researchers will enroll 628 participants at three hospitals in China. Participants will be randomly assigned to two groups:

  • Individualized inspired oxygen titration group: The anesthesiologist will adjust the oxygen concentration according to blood oxygen saturation, measured continuously using a pulse oximeter.
  • Pure oxygen group: The anesthesiologist will maintain 100% oxygen from the start of general anesthesia until removal of the tracheal tube.

Both groups will receive 100% oxygen before one-lung ventilation begins. In the individualized group, oxygen adjustment will continue after ventilation of both lungs resumes. Before removal of the tracheal tube, the anesthesiologist may raise the oxygen concentration for safety. Both groups will receive treatment if blood oxygen levels become too low.

Researchers will assess participants during hospitalization and through 30 days after surgery. Follow-up after discharge will take place by telephone or outpatient assessment. Researchers will compare deaths and major complications affecting the lungs, heart, brain, or kidneys. They will also assess recovery and safety.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

628

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Kina
      • Shanghai, Kina, 200433
    • Anhui
      • Hefei, Anhui, Kina, 230001
        • Anhui Provincial Cancer Hospital
        • Kontakt:
    • Jiangsu
      • Nanjing, Jiangsu, Kina, 210003

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 100 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Able and willing to provide written informed consent.
  • Age 18 years or older.
  • Scheduled for elective unilateral lung surgery requiring one-lung ventilation, with an anticipated one-lung ventilation duration of more than 1 hour.
  • American Society of Anesthesiologists (ASA) physical status I-III.

Exclusion Criteria:

  • Pregnancy or lactation.
  • History of thoracic surgery.
  • New York Heart Association class III-IV heart failure or Canadian Cardiovascular Society class III-IV coronary artery disease.
  • Acute cardiovascular or cerebrovascular disease within the preceding 6 months or renal insufficiency requiring dialysis.
  • Intracranial injury or tumor.
  • Psychiatric illness, cognitive impairment, communication or language difficulties, or other circumstances expected to prevent follow-up or data collection.
  • Participation in another interventional trial.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Individualized inspired oxygen fraction titration group

Participants will receive individualized inspired oxygen titration from OLV beginning
Andet: Individualized inspired oxygen fraction titration

FiO2 will be 1.0 from anesthesia induction until one-lung ventilation begins. Thereafter, FiO2 will be titrated in steps of 0.05 within 0.4-1.0 to identify the lowest concentration maintaining SpO2 ≥ 92%. At SpO2 of 90%-91%, downward titration will stop and FiO2 will be increased. SpO2 below 90% will trigger the prespecified hypoxemia rescue protocol. Titration may resume once oxygenation recovers and stabilizes, as judged by the attending anesthesiologist. The same strategy will continue after two-lung ventilation resumes. Before extubation, FiO2 may be increased for oxygen reserve.
Aktiv komparator: Pure oxygen group

The fraction of inspired oxygen (FiO2) will be maintained at 1.0 from anesthesia induction until tracheal extubation.
Andet: Continuous ventilation with 100% oxygen

FiO2 will be maintained at 1.0 from anesthesia induction until tracheal extubation, including during one-lung ventilation and after two-lung ventilation resumes.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Proportion of participants developing one or more major adverse events (MAEs)
Tidsramme: The first 30 postoperative days

all-cause death; postoperative pulmonary complications (pneumonia; ARDS; atelectasis; respiratory failure; pulmonary embolism; pneumothorax on the nonoperated side); cardiac events (new-onset atrial fibrillation or flutter, ventricular tachycardia or ventricular fibrillation requiring treatment; myocardial infarction; heart failure); neurological complications (stroke, transient ischemic attack, delirium); acute kidney injury defined as postoperative creatinine level at least doubled from the preoperative level or kidney replacement therapy.
The first 30 postoperative days

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Længde af hospitalsophold
Tidsramme: Fra operationsdagen til udskrivelsesdagen op til dag 90
Fra operationsdagen til udskrivelsesdagen op til dag 90
Duration of chest tube drainage
Tidsramme: Through study completion, an average of 3 days
Through study completion, an average of 3 days
Reintubation
Tidsramme: The first 30 postoperative days

Proportion of participants requiring tracheal reintubation after initial postoperative extubation
The first 30 postoperative days
Hospital readmission
Tidsramme: The first 30 postoperative days

Proportion of participants readmitted to a hospital after discharge from the index hospitalization and within 30 days after surgery.
The first 30 postoperative days
Sepsis
Tidsramme: The first 30 postoperative days

Proportion of participants developing sepsis, defined according to Sepsis-3
The first 30 postoperative days
Surgical site infection
Tidsramme: The first 30 postoperative days

Proportion of participants developing surgical site infection
The first 30 postoperative days

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Severe hypoxemia
Tidsramme: During surgery

Defined as peripheral oxygen saturation (SpO2) ≤85% for at least 10 seconds
During surgery
Rescue measures for hypoxemia
Tidsramme: During surgery

Proportion of participants receiving prespecified rescue measure for intraoperative hypoxemia (SpO2 below 90%)
During surgery

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Shanghai Pulmonary Hospital, Shanghai, China

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

20. december 2026

Primær færdiggørelse (Anslået)

31. januar 2028

Studieafslutning (Anslået)

1. marts 2028

Datoer for studieregistrering

Først indsendt

30. oktober 2026

Først indsendt, der opfyldte QC-kriterier

4. november 2026

Først opslået (Faktiske)

5. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

5. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2025LY11105

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

Deidentified individual participant data underlying the published study results will be available to qualified researchers upon reasonable request. Sharing will be subject to review of the proposed research, applicable ethical approvals, institutional requirements, and data protection requirements. Individual participant data will not be publicly accessible.

IPD-delingstidsramme

Requests will be considered beginning 6 months after publication of the main study results.

IPD-delingsadgangskriterier

Researchers should submit a methodologically sound research proposal and analysis plan to the corresponding author. Requests will be reviewed by the study leadership team. Access to the minimum necessary deidentified data and supporting documents will require approval of the proposal, any necessary ethical and institutional approvals, and a signed data use agreement.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP

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