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

4. november 2026 oppdatert av: 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.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

628

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Kina
      • Shanghai, Kina, 200433
        • Shanghai Pulmonary Hospital
        • Ta kontakt med:
        • Ta kontakt med:
    • Anhui
      • Hefei, Anhui, Kina, 230001
        • Anhui Provincial Cancer Hospital
        • Ta kontakt med:
    • Jiangsu
      • Nanjing, Jiangsu, Kina, 210003
        • The Second Hospital of Nanjing
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 100 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Individualized inspired oxygen fraction titration group

Participants will receive individualized inspired oxygen titration from OLV beginning
Annen: 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.
Annen: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
Tidsramme
Lengde på sykehusopphold
Tidsramme: Fra operasjonsdagen til utskrivningsdagen, opp til dag 90
Fra operasjonsdagen til utskrivningsdagen, opp 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
Tiltaksbeskrivelse
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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Shanghai Pulmonary Hospital, Shanghai, China

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

20. desember 2026

Primær fullføring (Antatt)

31. januar 2028

Studiet fullført (Antatt)

1. mars 2028

Datoer for studieregistrering

Først innsendt

30. oktober 2026

Først innsendt som oppfylte QC-kriteriene

4. november 2026

Først lagt ut (Faktiske)

5. november 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

5. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

4. november 2026

Sist bekreftet

1. november 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 2025LY11105

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (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.

Tilgangskriterier for IPD-deling

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 Støtteinformasjonstype

  • STUDY_PROTOCOL
  • SEVJE

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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