Tokyo, Aug. 19 -- UMIN Clinical Trials Registry (UMIN-CTR) received information related to the study (UMIN000058829) titled 'Association between Acute Respiratory Acidosis and Hyperkalemia During Esophageal Cancer Surgery in the Prone Position: A Retrospective Observational Study' on Aug. 19.
Study Type:
Observational
Primary Sponsor:
Institute - Aichi Medical University
Condition:
Condition - Esophageal cancer
Classification by malignancy - Malignancy
Genomic information - NO
Objective:
Narrative objectives1 - Prone positioning has become an increasingly common approach for thoracoscopic esophageal cancer surgery to facilitate surgical exposure. It has been associated with better surgical outcomes and improved perioperative safety compared to the classical lateral decubitus position. However, it may significantly impact ventilation. Partial lung collapse and intrathoracic insufflation of carbon dioxide (CO2), commonly used in these procedures, may contribute to abrupt shifts in respiratory physiology and acid-base balance. Clinically, transient elevations in serum potassium levels associated with acute respiratory acidosis are often observed during these surgeries. While acidosis is generally known to affect potassium distribution, respiratory acidosis is typically considered to cause only mild increases in serum potassium compared to metabolic acidosis. However, recent clinical reports challenge this view in the setting of critical illness; for instance, Pathak and Nanda described cases of severe, refractory hyperkalemia in COVID-19 patients where acute respiratory acidosis was identified as a major contributing factor. Nevertheless, the combination of prone positioning, ventilatory compromise, and CO2 insufflation may alter the expected
physiological response. This study aims to investigate whether acute elevations in arterial carbon dioxide partial pressure (PaCO2) during esophageal cancer surgery in the prone position are associated with significant increases in serum potassium levels, and to explore the clinical implications of these changes. This research may contribute to establishing safer ventilation strategies and optimizing electrolyte management during these procedures.
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Basic objectives2 - Others
Eligibility:
Age-lower limit - 20
years-old
<=
Age-upper limit - Not applicable
Gender - Male and Female
Key inclusion criteria - Patients who underwent thoracoscopic esophagectomy (including robot-assisted surgery) in the prone position.
Key exclusion criteria - Patients undergoing chronic dialysis
Patients with severe electrolyte abnormalities (defined as a preoperative serum potassium level of 5.0 mEq/L or higher)
Patients who received intraoperative massive transfusion (defined as having received a transfusion for a blood loss of 2000 ml or more)
Target Size - 150
Recruitment Status:
Recruitment status - No longer recruiting
Date of protocol fixation - 2025 Year 07 Month 21 Day
Date of IRB - 2025 Year 07 Month 22 Day
Anticipated trial start date - 2025 Year 07 Month 22 Day
Last follow-up date - 2027 Year 03 Month 31 Day
To know more, visit https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000067264
Disclaimer: Curated by HT Syndication.
