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

4 november 2026 uppdaterad 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Beräknad)

628

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 100 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Individualized inspired oxygen fraction titration group

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

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Proportion of participants developing one or more major adverse events (MAEs)
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Längden på sjukhusvistelsen
Tidsram: Från operationsdagen till utskrivningsdagen upp till dag 90
Från operationsdagen till utskrivningsdagen upp till dag 90
Duration of chest tube drainage
Tidsram: Through study completion, an average of 3 days
Through study completion, an average of 3 days
Reintubation
Tidsram: The first 30 postoperative days

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

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

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

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Severe hypoxemia
Tidsram: During surgery

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

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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Shanghai Pulmonary Hospital, Shanghai, China

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

20 december 2026

Primärt slutförande (Beräknad)

31 januari 2028

Avslutad studie (Beräknad)

1 mars 2028

Studieregistreringsdatum

Först inskickad

30 oktober 2026

Först inskickad som uppfyllde QC-kriterierna

4 november 2026

Första postat (Faktisk)

5 november 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

5 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

4 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 2025LY11105

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

JA

IPD-planbeskrivning

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.

Tidsram för IPD-delning

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

Kriterier för IPD Sharing Access

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-delning som stöder informationstyp

  • STUDY_PROTOCOL
  • SAV

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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