Trial reportBMC pulmonary medicine2026
Effects of various hypoxic preconditioning strategies on arterial oxygenation in patients undergoing one-lung ventilation during thoracoscopic surgery: a randomized clinical trial.
Trial report in BMC pulmonary medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOne-lung ventilation (OLV) during thoracoscopic right lung resection can lead to challenges in maintaining arterial oxygenation and postoperative pulmonary complications. Hypoxic preconditioning (HPC) may improve outcomes in this setting. This study aimed to investigate the effects of different HPC strategies on arterial oxygenation during OLV and the incidence of postoperative pulmonary complications.
methodsThis randomized controlled trial enrolled patients undergoing elective thoracoscopic right lung resection at the First Affiliated Hospital of Dalian Medical University from March 2022 to August 2022. Participants were randomly assigned to three groups in a 1:1:1 ratio: the I-HPC group receiving intermittent HPC, the C-HPC group receiving continuous HPC, and the RV group receiving regular two-lung ventilation (control group). Arterial blood gas analysis was conducted at five time points: at baseline prior to oxygen inhalation (T0), before the opening of the pleura (T1), and at 5 min (T2), 15 min (T3), and 30 min (T4) after the initiation of OLV. The primary outcome was the arterial oxygen partial pressure (PaO2) throughout the OLV period.
resultsBaseline arterial PaO₂ at T0 did not differ significantly among the three groups. The I-HPC group showed significantly higher PaO2 (mmHg) at T3 (214.27 ± 74.38 vs. 167.80 ± 65.68, P = 0.015) and T4 (221.80 ± 74.67 vs. 177.03 ± 70.94, P = 0.023) compared to the control group. The C-HPC group also had significantly higher PaO2 at T3 (217.35 ± 76.10 vs. 167.80 ± 65.68, P = 0.009) and T4 (220.81 ± 78.58 vs. 177.03 ± 70.94, P = 0.023) relative to the control group. No significant differences were found among the groups regarding intraoperative oxygen saturation, arterial blood gas values, respiratory and circulatory indicators, vasoactive drug usage, or postoperative pulmonary complications (all P > 0.05).
conclusionsHypoxic preconditioning of the nondependent lung prior to pleural incision may enhance arterial oxygenation during OLV, suggesting that HPC could serve as a supportive measure for patients undergoing elective thoracoscopic lung resection.
trial registrationThis study was registered on March 27th, 2022, in the Chinese Clinical Trial Registry (ChiCTR2200058026), prior to enrollment of the first participant, and no protocol changes were made after trial initiation.
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