CClinicalTrials.gg
CompletedNCT03317431Updated Oct 22, 2018Results posted

the Effect of Dopamine on Mechanical Ventilation Induced Lung Injury

An observational study in Acute Lung Injury, sponsored by Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Completed at 1 site in China. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2018-10-22.

Sponsored by Xinhua Hospital, Shanghai Jiao Tong University School of Medicine · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
46
Ages
18 Years to 60 Years
Sex
All
01

Study summary

Dopamine(DA) is a common neurotransmitter that has been known to regulate behavior, movement, cardiovascular,endocrine and gastrointestinal functions, but also functions as an important molecule engaging in the immune systems to possess anti-inflammatory effects. However, its role in ventilator-induced lung injury (VILI) is still unclear. Herein, this study aimed to investigate the therapeutic efficacy of dopamine on ventilation-induced lung endothelial barrier dysfunction and explore the possible underlying molecular mechanisms.

Read the detailed description

Mechanical ventilation is a critical intervention for patients with acute respiratory failure. However, lung overdistension induced by mechanical ventilation at high tidal volumes also causes pulmonary endothelial dysfunction. The injurious effect of mechanical stretch on pulmonary endothelium has been implicated in the development of ventilator-induced lung injury (VILI), which is characterized by pulmonary inflammation and particularly increased vascular permeability. In addition, the investigators and others have previously shown that mechanical stretch increases cultured lung endothelial monolayer permeability in vitro and promotes lung vascular permeability in mice Thus, elucidating the mechanisms underlying the mechanical stretch-induced lung endothelial barrier dysfunction may provide a novel clinical therapeutic target against VILI.

Dopamine is a neurotransmitter, which can also be produced outside the central nervous system. Lung alveolar epithelial cells represent an important source of extraneuronal dopamine, which has a significant role in local organ physiology. Dopamine D1 receptor (DRD1) and D2 receptor (DRD2) are present in lung tissues. Activation of D2DR induces NaKATPase gene expression. Moreover, activation of DRD1 results in the trafficking of NaKATPase to the basolateral membrane of type II alveolar epithelial cells, thus increasing lung liquid clearance during acute lung injury. Although the lung-protective effects of DA and its implication in the pathology of ALI are emerging, the mechanisms are still largely unknown.

In the present study, the investigators will analyze the influence of mechanical ventilation on dopamine receptors in the lung tissue of the participants, and explore whether DA could protect ventilation induced lung injury, which is helpful for prevention and treatment of ventilation induced lung injury.

02

Conditions studied

  • Acute Lung Injury

Keywords

  • dopamine,mechanical ventilation,lung injury
03

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

patients undergo elective lobectom

Inclusion criteria

  • Patients inclusion criteria: undergo elective lobectomy with general anesthesia and mechanical ventilation; classified as physical status I to III according to the American Society of Anesthesiologists Physical Status Classification System; Written informed consent is approved.

Exclusion criteria

Exclusion Criteria:

  • Distant metastases: recent anaesthetics or mechanical ventilation treatment;children;women during pregnancy or lactation; being involved in other clinical subjects.
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
46 participants (actual)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • ventilation

    patients undergoing selective operation with general anesthesia(GA) and mechanical ventilation(MV)

    Other: mechanical ventilation

Interventions

  • Othermechanical ventilation

    mechanical ventilation protocol: tidal volume 6-8 ml/kg, positive end-expiratory pressure 5 cmH2O, oxygen concentration 40%; respiratory rate 10-15/min, inspiratory/expiratory ratio 1:1.5.

05

What researchers measure

Primary outcomes

  1. Correlation Coefficient (r) Between Duration of Mechanical Ventilation and DRD1 Expression

    ImageJ software were used to get the Integrated Optical Density(IOD) of the chemiluminescent signal from the membranes of dopamine receptor 1(DRD1). The normalization was carried out by DRD1 IOD/total β-actin IOD for sample loading correction. In determination of the expression level of DRD1 in different time points, the investigators had a bulk preparation of normal placental protein which was set as a control. Analyze the correlation between duration of mechanical ventilation and DRD1 expression. If p value is less than 0.05, then its change is statically significant.

    Time frame: 20min-60min

Secondary outcomes

  1. Correlation Coefficient (r) Between Duration of Mechanical Ventilation and DRD2 Expression

    ImageJ software were used to get the Integrated Optical Density(IOD) of the chemiluminescent signal from the membranes of dopamine receptor 2(DRD2). The normalization was carried out by DRD2 IOD/total β-actin IOD for sample loading correction. In determination of the expression level of DRD2 in different time points, the investigators had a bulk preparation of normal placental protein which was set as a control. Analyze the correlation between duration of mechanical ventilation and DRD2 expression. If p value is less than 0.05, then its change is statically significant.

    Time frame: 20min-60min

  2. the Expression of TH in Lung Tissues

    ImageJ software were used to get the Integrated Optical Density(IOD) of the chemiluminescent signal from the membranes of Tyrosine hydroxylase(TH). The normalization was carried out by TH IOD/total β-actin IOD for sample loading correction. In determination of the expression level of TH in different time points, the investigators had a bulk preparation of normal placental protein which was set as a control. Analyze the correlation between duration of mechanical ventilation and TH expression. If p value is less than 0.05, then its change is statically significant.

    Time frame: 20min-60min

  3. the Expression of DDC in Lung Tissues

    ImageJ software were used to get the Integrated Optical Density(IOD) of the chemiluminescent signal from the membranes of Dopa decarboxylase(DDC). The normalization was carried out by DDC IOD/total β-actin IOD for sample loading correction. In determination of the expression level of DDC in different time points, the investigators had a bulk preparation of normal placental protein which was set as a control. Analyze the correlation between duration of mechanical ventilation and DDC expression. If p value is less than 0.05, then its change is statically significant.

    Time frame: 20min-60min

  4. the Expression of Ac-a-tubulin in Lung Tissues

    ImageJ software were used to get the Integrated Optical Density(IOD) of the chemiluminescent signal from the membranes of acetylated-a-tubulin(Ac-a-tubulin). The normalization was carried out by Ac-a-tubulin IOD/total β-actin IOD for sample loading correction. In determination of the expression level of Ac-a-tubulin in different time points, the investigators had a bulk preparation of normal placental protein which was set as a control. Analyze the correlation between duration of mechanical ventilation and Ac-a-tubulin expression. If p value is less than 0.05, then its change is statically significant.

    Time frame: 20min-60min

06

Results

Posted Oct 22, 2018

Participant flow

Participant flow — Overall Study
MilestoneVentilation
Started46
Completed46
Not completed0

Outcome measures

PrimaryCorrelation Coefficient (r) Between Duration of Mechanical Ventilation and DRD1 Expression

ImageJ software were used to get the Integrated Optical Density(IOD) of the chemiluminescent signal from the membranes of dopamine receptor 1(DRD1). The normalization was carried out by DRD1 IOD/total β-actin IOD for sample loading correction. In determination of the expression level of DRD1 in different time points, the investigators had a bulk preparation of normal placental protein which was set as a control. Analyze the correlation between duration of mechanical ventilation and DRD1 expression. If p value is less than 0.05, then its change is statically significant.

Time frame:
20min-60min
Reported as:
Number · pearson Correlation Coefficient
Correlation Coefficient (r) Between Duration of Mechanical Ventilation and DRD1 Expression
pearson Correlation CoefficientVentilation
Correlation Coefficient (r) Between Duration of Mechanical Ventilation and DRD1 Expression-0.555
Statistical analysis
  • Ventilation · Regression, Linear · p = <0.01
SecondaryCorrelation Coefficient (r) Between Duration of Mechanical Ventilation and DRD2 Expression

ImageJ software were used to get the Integrated Optical Density(IOD) of the chemiluminescent signal from the membranes of dopamine receptor 2(DRD2). The normalization was carried out by DRD2 IOD/total β-actin IOD for sample loading correction. In determination of the expression level of DRD2 in different time points, the investigators had a bulk preparation of normal placental protein which was set as a control. Analyze the correlation between duration of mechanical ventilation and DRD2 expression. If p value is less than 0.05, then its change is statically significant.

Time frame:
20min-60min
Reported as:
Number · pearson Correlation coefficient
Correlation Coefficient (r) Between Duration of Mechanical Ventilation and DRD2 Expression
pearson Correlation coefficientVentilation
Correlation Coefficient (r) Between Duration of Mechanical Ventilation and DRD2 Expression0.094
Statistical analysis
  • Ventilation · Regression, Linear · p = >0.01
Secondarythe Expression of TH in Lung Tissues

ImageJ software were used to get the Integrated Optical Density(IOD) of the chemiluminescent signal from the membranes of Tyrosine hydroxylase(TH). The normalization was carried out by TH IOD/total β-actin IOD for sample loading correction. In determination of the expression level of TH in different time points, the investigators had a bulk preparation of normal placental protein which was set as a control. Analyze the correlation between duration of mechanical ventilation and TH expression. If p value is less than 0.05, then its change is statically significant.

Time frame:
20min-60min
Reported as:
Number · pearson correlation coefficient
the Expression of TH in Lung Tissues
pearson correlation coefficientVentilation
the Expression of TH in Lung Tissues-0.047
Statistical analysis
  • Ventilation · Regression, Linear · p = >0.01
Secondarythe Expression of DDC in Lung Tissues

ImageJ software were used to get the Integrated Optical Density(IOD) of the chemiluminescent signal from the membranes of Dopa decarboxylase(DDC). The normalization was carried out by DDC IOD/total β-actin IOD for sample loading correction. In determination of the expression level of DDC in different time points, the investigators had a bulk preparation of normal placental protein which was set as a control. Analyze the correlation between duration of mechanical ventilation and DDC expression. If p value is less than 0.05, then its change is statically significant.

Time frame:
20min-60min
Reported as:
Number · pearson correlation coefficient
the Expression of DDC in Lung Tissues
pearson correlation coefficientVentilation
the Expression of DDC in Lung Tissues-0.012
Statistical analysis
  • Ventilation · Regression, Linear · p = >0.01
Secondarythe Expression of Ac-a-tubulin in Lung Tissues

ImageJ software were used to get the Integrated Optical Density(IOD) of the chemiluminescent signal from the membranes of acetylated-a-tubulin(Ac-a-tubulin). The normalization was carried out by Ac-a-tubulin IOD/total β-actin IOD for sample loading correction. In determination of the expression level of Ac-a-tubulin in different time points, the investigators had a bulk preparation of normal placental protein which was set as a control. Analyze the correlation between duration of mechanical ventilation and Ac-a-tubulin expression. If p value is less than 0.05, then its change is statically significant.

Time frame:
20min-60min
Reported as:
Number · pearson correlation coefficient
the Expression of Ac-a-tubulin in Lung Tissues
pearson correlation coefficientVentilation
the Expression of Ac-a-tubulin in Lung Tissues-0.465
Statistical analysis
  • Ventilation · Regression, Linear · p = <0.01

Adverse events

Collected over 20-60 min. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Ventilation———

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Ventilation
<=18 years0
Between 18 and 65 years46
>=65 years0
Sex: Female, Male
Sex: Female, Male(Participants)Ventilation
Female13
Male33
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Ventilation
American Indian or Alaska Native0
Asian46
Native Hawaiian or Other Pacific Islander0
Black or African American0
White0
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Ventilation
China46
07

Study locations

1 site
  • Department of Anesthesia, Shanghai Xinhua hospital
    Shanghai, Shanghai 200082, China
08

References and documents

Study documents

  • Informed consent form · Aug 1, 2017
  • Protocol and statistical analysis plan · Aug 1, 2017

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03317431
Lead sponsor
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
Responsible party
Sponsor
First posted
Oct 23, 2017
Start date
Mar 20, 2017
Primary completion
Oct 22, 2017
Completion
Dec 1, 2017
Results posted
Oct 22, 2018
Last update
Oct 22, 2018

Study contacts

Lai Jiang, chief doctor
study chair · Xinhua Hospital affiliated to Medicine school,Shanghai Jiaotong University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
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