<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02191410</url>
  </required_header>
  <id_info>
    <org_study_id>N2014045</org_study_id>
    <nct_id>NCT02191410</nct_id>
  </id_info>
  <brief_title>Nondependent Lung Ventilation and Fluid Responsiveness</brief_title>
  <official_title>Comparative Study of the Non-dependent Continuous Positive Airway Pressure and High-frequency Positive-pressure Ventilation on Fluid Responsiveness During One-lung Ventilation for Thoracoscopic Surgery</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Imam Abdulrahman Bin Faisal University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Imam Abdulrahman Bin Faisal University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The stroke volume variation (SVV), measured using the Vigileo-FloTrac system (Edwards&#xD;
      Lifescience, Irvine, CA), has been shown to able to predict fluid responsiveness during&#xD;
      one-lung ventilation (OLV) in patients undergoing pulmonary lobectomy (sensitivity: 82.4%,&#xD;
      specificity: 92.3%).1 Many parameters such as tidal volume (TV),1-2 positive end-expiratory&#xD;
      pressure (PEEP),3 respiratory rate (RR), 4 chest and lung compliance,5 heart rate and rhythm,&#xD;
      and ventricular function and afterload,6-7 all have been documented to have effects on the&#xD;
      SVV.&#xD;
&#xD;
      SVV is calculated as the variation of beat-to-beat SV from the mean value during the most&#xD;
      recent 20 seconds of data: SVV = (SVmax - SVmin)/SVmean, where SVmax, SVmin, and SVmean are,&#xD;
      respectively, the maximum, minimum, and mean SV determined by the system.&#xD;
&#xD;
      SVV may not be sufﬁciently sensitive to predict fluid responsiveness in patients with right&#xD;
      ventricular (RV) dysfunction due to concomitant increases in RV afterload, that lead to a&#xD;
      decrease in preload variation and subsequent inaccuracy in SVV measurements.8&#xD;
&#xD;
      OLV may increase airway pressure, resulting in increases in the RV afterload, end-diastolic&#xD;
      volume, and stroke work index, thus impeding RV function.9-11The increases in the right&#xD;
      ventricular afterload may exaggerate the cyclic variation in stroke volume.12&#xD;
&#xD;
      In the authors' previous study,9 they found that the high-frequency positive-pressure&#xD;
      ventilation (HFPPV) was superior to continuous positive-airway pressure (CPAP) for OLV,&#xD;
      resulting in significantly higher RV ejection fraction, lower RV afterload and higher&#xD;
      arterial oxygenation, whereas the former limiting the adequate operative field visualization&#xD;
      during video-assisted thoracoscopic surgery (VATS).13&#xD;
&#xD;
      The effects of the nondependent lung ventilation with HFPPV and CPAP on the SVV and fluid&#xD;
      responsiveness during OLV has not yet been studied.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      In all patients, standard monitors, and state and response entropy (SE and RE, respectively)&#xD;
      based-depth of anesthesia will be applied. Normothermia will be maintained by using&#xD;
      forced-air warming blankets. Anesthetic technique will be standardized in all studied&#xD;
      patients. Anesthesiologists who give the anesthetic will be not involved in the collection of&#xD;
      outcome data. General anesthesia will be induced with propofol (2-3 mg kg-1) and fentanyl&#xD;
      (2-3 µg kg-1) to achieve a SE value less than 50 and the difference between RE and SE less&#xD;
      than 10.&#xD;
&#xD;
      Cisatracurium (0.2mg kg-1) will be administered to facilitate the placement of a left-sided&#xD;
      double-lumen tube, and the correct position of its tip will be confirmed with a fiberoptic&#xD;
      bronchoscope.&#xD;
&#xD;
      Anesthesia will be maintained with 0.7 to 1.5 minimum alveolar concentration of sevoflurane&#xD;
      and 0.5 µg kg-1 increments of fentanyl to maintain the SE values less than 50 and the&#xD;
      difference between RE and SE less than 10. Suppression of the second twitch in train-of-four&#xD;
      stimulation of the ulnar nerve will be maintained with 0.03mg kg-1 increments of&#xD;
      cisatracurium.&#xD;
&#xD;
      The radial artery will be catheterized. Cardiac index (CI) and SVV will be measured by using&#xD;
      a Vigileo-FloTrac system (v1.14, Edwards Lifescience, Irvine, CA).&#xD;
&#xD;
      Patients' two lungs (TLV) will be mechanically ventilated with a pressure-controlled&#xD;
      ventilation mode, a fraction of inspired oxygen (FiO2) of 0.4 in air, TV of 8 mL kg-1&#xD;
      (predicted body weight (PBW)), inspiratory to expiratory (I: E) ratio of 1:2.5 and PEEP of 5&#xD;
      cm H2O, fresh gas flow (FGF) of 1.5-1.7 L min-1, and RR adjusted to achieve a PaCO2 of 35-45&#xD;
      mm Hg.&#xD;
&#xD;
      During OLV,TV, FiO2, I: E ratio, PEEP, FGF, and RR, will be maintained as during TLV and the&#xD;
      lumen of the nondependent lung will be left open to air.&#xD;
&#xD;
      After thoracostomy, patients will be randomly allocated to one of two by drawing sequentially&#xD;
      numbered sealed opaque envelopes containing a computer-generated randomization code.&#xD;
&#xD;
      The patient's nondependent lung during OLV will be ventilated with a CPAP of 2 cm H2O or&#xD;
      HFPPV as randomized.&#xD;
&#xD;
      All patients will receive lactated Ringer's solution at 2mL kg-1 h-1 during surgery. The&#xD;
      capability of SVV to predict fluid responsiveness during CPAP or HFPPV will be assessed at 30&#xD;
      min after randomization.&#xD;
&#xD;
      Hemodynamic control will be standardized according to the authors' protocol. If MAP dropped&#xD;
      down to 60 mmHg, 250 mL of plasma protein fraction 5% will be administered, and, if this will&#xD;
      not enough, repeated doses of intravenous of ephedrine 5 mg or phenylephrine 100 µg, will be&#xD;
      administered to maintain urine output to be equal or greater than 0.5 mL kg-1 hour-1. A&#xD;
      hemoglobin concentration of 8 g dL-1 or greater will be compensated with red blood cell&#xD;
      concentrates.&#xD;
&#xD;
      An independent investigator blinded to the study groups who will not be involved in the&#xD;
      patients' management collected the data.&#xD;
&#xD;
      As in previous studies,14-15 the sample size is determined by considering that an area under&#xD;
      the ROC curve ≥ 0.8 is clinically reliable to predict fluid responsiveness. To detect a 0.3&#xD;
      difference from the null hypothesis of 0.5, 28 patients will be required in each group with a&#xD;
      type-I error of 0.05 and a power of 80% under the ROC curve, assuming equal number of&#xD;
      responders and non-responders. To compensate for a dropout rate of 10%, 31 patients will be&#xD;
      included in each group.&#xD;
&#xD;
      Normal distributions of data will be assessed using Kolmogorov-Smirnov test. Student's paired&#xD;
      t-test or the Wilcoxon signed-rank test will be used to compare hemodynamic variables&#xD;
      obtained at the 2 time points (T0, T1) before and after volume expansion. Hemodynamic&#xD;
      variables between responders and non-responders within the group at each time point will be&#xD;
      compared using Student independent t-test or Mann-Whitney U-test where appropriate. The x2&#xD;
      test will be used when indicated. The Pearson rank method tests linear correlations between&#xD;
      SVV before volume loading (T0) and absolute changes in SVV (∆SVV) and percentage change in&#xD;
      SVI (∆SVI) after volume. The responders are defined as those patients who demonstrates a ≥&#xD;
      15% increase in CI after volume expansion between T0 and T1.16 A ROC curve for each variable&#xD;
      will be generated and an area under the ROC curve will be calculated. Using this analysis,&#xD;
      the optimal threshold value, sensitivity and specificity of SVV during each study&#xD;
      intervention could be determined. The ROC curves will be compared using the DeLong test. Data&#xD;
      will be expressed as mean ± SD, medians [IQR], or number (%). A value of p&lt; 0.05 is&#xD;
      considered to be statistically significant.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Not yet recruiting</last_known_status>
  <start_date type="Anticipated">January 2019</start_date>
  <completion_date type="Anticipated">June 2020</completion_date>
  <primary_completion_date type="Anticipated">April 2020</primary_completion_date>
  <phase>Phase 3</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Fluid responsiveness</measure>
    <time_frame>5 min after volume loading</time_frame>
    <description>To explore the ability of SVV to predict fluid responsiveness with ROC plots</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Heart rate</measure>
    <time_frame>5 min before volume loading, 5 min after volume loading</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Stroke volume variation</measure>
    <time_frame>5 min before volume loading, 5 min after volume loading</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Mean blood pressure</measure>
    <time_frame>5 min before volume loading, 5 min after volume loading</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Cardiac index</measure>
    <time_frame>5 min before volume loading, 5 min after volume loading</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Stroke Volume Index</measure>
    <time_frame>5 min before volume loading, 5 min after volume loading</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Airway pressures</measure>
    <time_frame>5 min before volume loading, 5 min after volume loading</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Lung Compliance</measure>
    <time_frame>5 min before volume loading, 5 min after volume loading</time_frame>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">62</enrollment>
  <condition>Lung Disease</condition>
  <condition>Undergoing Thoracosocpic Surgery</condition>
  <arm_group>
    <arm_group_label>High Frequency Positive Pressure Ventilation</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
  </arm_group>
  <arm_group>
    <arm_group_label>Continuous Positive Airway Pressure</arm_group_label>
    <arm_group_type>Placebo Comparator</arm_group_type>
  </arm_group>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>High Frequency Positive Pressure Ventilation</intervention_name>
    <description>TV 2 mL kg-1 PBW, I:E ratio &gt; 0.3, RR 60 breaths min-1 and a FGF of &lt; 2 L min-1, using a second identical ventilator with low compliant internal circuit</description>
    <arm_group_label>High Frequency Positive Pressure Ventilation</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Continuous Positive Airway Pressure</intervention_name>
    <description>CPAP of 2 cm H2O</description>
    <arm_group_label>Continuous Positive Airway Pressure</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  American Society of Anesthesiologists physical class of II to III&#xD;
&#xD;
          -  Duration of OLV is expected to exceed 1.5 hours&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  New York Heart Association class &gt; II&#xD;
&#xD;
          -  Right ventricular dysfunction&#xD;
&#xD;
          -  Pulmonary hypertension&#xD;
&#xD;
          -  valvular heart disease&#xD;
&#xD;
          -  intracardiac shunts&#xD;
&#xD;
          -  Any cardiac rhythm other than sinus&#xD;
&#xD;
          -  Hypertension&#xD;
&#xD;
          -  Diabetes mellitus&#xD;
&#xD;
          -  Renal dysfunction&#xD;
&#xD;
          -  Hepatic dysfunction&#xD;
&#xD;
          -  Pregnancy&#xD;
&#xD;
          -  Body mass index &gt;35 kg m-2&#xD;
&#xD;
          -  Peripheral arterial occlusive disease&#xD;
&#xD;
          -  preoperative administration of inotropic medications&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>70 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Abdulmohsen A Al Ghamdi, MD</last_name>
    <role>Study Chair</role>
    <affiliation>Chairman of Anesthesiology Dept</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Mohamed R El Tahan, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Imam Abdulrahman Bin Faisal University</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Mohamed R El Tahan, MD</last_name>
    <phone>+966 13 865 1193</phone>
    <email>mohamedrefaateltahan@yahoo.com</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Abdulmohsin A Al Ghamdi, MD</last_name>
    <phone>+966 50 581 4737</phone>
    <email>mohsenkfu@hotmail.com</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>King Fahd Hospital of the University</name>
      <address>
        <city>Khobar</city>
        <state>Eastern</state>
        <zip>31952</zip>
        <country>Saudi Arabia</country>
      </address>
    </facility>
    <contact>
      <last_name>Abdulmohsen A Al Ghamdi, MD</last_name>
      <phone>+966 13 8966666</phone>
      <phone_ext>2021</phone_ext>
      <email>mohsenkfu@hotmail.com</email>
    </contact>
    <investigator>
      <last_name>Mohamed R El Tahan, MD</last_name>
      <role>Principal Investigator</role>
    </investigator>
    <investigator>
      <last_name>Abdulmohsen A Al Ghamdi, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Saudi Arabia</country>
  </location_countries>
  <verification_date>May 2018</verification_date>
  <study_first_submitted>July 12, 2014</study_first_submitted>
  <study_first_submitted_qc>July 14, 2014</study_first_submitted_qc>
  <study_first_posted type="Estimate">July 16, 2014</study_first_posted>
  <last_update_submitted>May 22, 2018</last_update_submitted>
  <last_update_submitted_qc>May 22, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">May 24, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Video-assisted thoracoscopic surgery</keyword>
  <keyword>one-lung ventilation</keyword>
  <keyword>continuous positive-airway ventilation</keyword>
  <keyword>high-frequency positive-pressure ventilation</keyword>
  <keyword>stroke volume variation</keyword>
  <keyword>fluid responsiveness</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Lung Diseases</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02191410
org study id: N2014045
nct id: NCT02191410
lead sponsor: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
The stroke volume variation (SVV), measured using the Vigileo-FloTrac system (Edwards
      Lifescience, Irvine, CA), has been shown to able to predict fluid responsiveness during
      one-lung ventilation (OLV) in patients undergoing pulmonary lobectomy (sensitivity: 82.4%,
      specificity: 92.3%).1 Many parameters such as tidal volume (TV),1-2 positive end-expiratory
      pressure (PEEP),3 respiratory rate (RR), 4 chest and lung compliance,5 heart rate and rhythm,
      and ventricular function and afterload,6-7 all have been documented to have effects on the
      SVV.

      SVV is calculated as the variation of beat-to-beat SV from the mean value during the most
      recent 20 seconds of data: SVV = (SVmax - SVmin)/SVmean, where SVmax, SVmin, and SVmean are,
      respectively, the maximum, minimum, and mean SV determined by the system.

      SVV may not be sufﬁciently sensitive to predict fluid responsiveness in patients with right
      ventricular (RV) dysfunction due to concomitant increases in RV afterload, that lead to a
      decrease in preload variation and subsequent inaccuracy in SVV measurements.8

      OLV may increase airway pressure, resulting in increases in the RV afterload, end-diastolic
      volume, and stroke work index, thus impeding RV function.9-11The increases in the right
      ventricular afterload may exaggerate the cyclic variation in stroke volume.12

      In the authors' previous study,9 they found that the high-frequency positive-pressure
      ventilation (HFPPV) was superior to continuous positive-airway pressure (CPAP) for OLV,
      resulting in significantly higher RV ejection fraction, lower RV afterload and higher
      arterial oxygenation, whereas the former limiting the adequate operative field visualization
      during video-assisted thoracoscopic surgery (VATS).13

      The effects of the nondependent lung ventilation with HFPPV and CPAP on the SVV and fluid
      responsiveness during OLV has not yet been studied.
In all patients, standard monitors, and state and response entropy (SE and RE, respectively)
      based-depth of anesthesia will be applied. Normothermia will be maintained by using
      forced-air warming blankets. Anesthetic technique will be standardized in all studied
      patients. Anesthesiologists who give the anesthetic will be not involved in the collection of
      outcome data. General anesthesia will be induced with propofol (2-3 mg kg-1) and fentanyl
      (2-3 µg kg-1) to achieve a SE value less than 50 and the difference between RE and SE less
      than 10.

      Cisatracurium (0.2mg kg-1) will be administered to facilitate the placement of a left-sided
      double-lumen tube, and the correct position of its tip will be confirmed with a fiberoptic
      bronchoscope.

      Anesthesia will be maintained with 0.7 to 1.5 minimum alveolar concentration of sevoflurane
      and 0.5 µg kg-1 increments of fentanyl to maintain the SE values less than 50 and the
      difference between RE and SE less than 10. Suppression of the second twitch in train-of-four
      stimulation of the ulnar nerve will be maintained with 0.03mg kg-1 increments of
      cisatracurium.

      The radial artery will be catheterized. Cardiac index (CI) and SVV will be measured by using
      a Vigileo-FloTrac system (v1.14, Edwards Lifescience, Irvine, CA).

      Patients' two lungs (TLV) will be mechanically ventilated with a pressure-controlled
      ventilation mode, a fraction of inspired oxygen (FiO2) of 0.4 in air, TV of 8 mL kg-1
      (predicted body weight (PBW)), inspiratory to expiratory (I: E) ratio of 1:2.5 and PEEP of 5
      cm H2O, fresh gas flow (FGF) of 1.5-1.7 L min-1, and RR adjusted to achieve a PaCO2 of 35-45
      mm Hg.

      During OLV,TV, FiO2, I: E ratio, PEEP, FGF, and RR, will be maintained as during TLV and the
      lumen of the nondependent lung will be left open to air.

      After thoracostomy, patients will be randomly allocated to one of two by drawing sequentially
      numbered sealed opaque envelopes containing a computer-generated randomization code.

      The patient's nondependent lung during OLV will be ventilated with a CPAP of 2 cm H2O or
      HFPPV as randomized.

      All patients will receive lactated Ringer's solution at 2mL kg-1 h-1 during surgery. The
      capability of SVV to predict fluid responsiveness during CPAP or HFPPV will be assessed at 30
      min after randomization.

      Hemodynamic control will be standardized according to the authors' protocol. If MAP dropped
      down to 60 mmHg, 250 mL of plasma protein fraction 5% will be administered, and, if this will
      not enough, repeated doses of intravenous of ephedrine 5 mg or phenylephrine 100 µg, will be
      administered to maintain urine output to be equal or greater than 0.5 mL kg-1 hour-1. A
      hemoglobin concentration of 8 g dL-1 or greater will be compensated with red blood cell
      concentrates.

      An independent investigator blinded to the study groups who will not be involved in the
      patients' management collected the data.

      As in previous studies,14-15 the sample size is determined by considering that an area under
      the ROC curve ≥ 0.8 is clinically reliable to predict fluid responsiveness. To detect a 0.3
      difference from the null hypothesis of 0.5, 28 patients will be required in each group with a
      type-I error of 0.05 and a power of 80% under the ROC curve, assuming equal number of
      responders and non-responders. To compensate for a dropout rate of 10%, 31 patients will be
      included in each group.

      Normal distributions of data will be assessed using Kolmogorov-Smirnov test. Student's paired
      t-test or the Wilcoxon signed-rank test will be used to compare hemodynamic variables
      obtained at the 2 time points (T0, T1) before and after volume expansion. Hemodynamic
      variables between responders and non-responders within the group at each time point will be
      compared using Student independent t-test or Mann-Whitney U-test where appropriate. The x2
      test will be used when indicated. The Pearson rank method tests linear correlations between
      SVV before volume loading (T0) and absolute changes in SVV (∆SVV) and percentage change in
      SVI (∆SVI) after volume. The responders are defined as those patients who demonstrates a ≥
      15% increase in CI after volume expansion between T0 and T1.16 A ROC curve for each variable
      will be generated and an area under the ROC curve will be calculated. Using this analysis,
      the optimal threshold value, sensitivity and specificity of SVV during each study
      intervention could be determined. The ROC curves will be compared using the DeLong test. Data
      will be expressed as mean ± SD, medians [IQR], or number (%). A value of p< 0.05 is
      considered to be statistically significant.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Single (Outcomes Assessor)
measure: Fluid responsiveness
time frame: 5 min after volume loading
description: To explore the ability of SVV to predict fluid responsiveness with ROC plots
measure: Heart rate
time frame: 5 min before volume loading, 5 min after volume loading
measure: Stroke volume variation
time frame: 5 min before volume loading, 5 min after volume loading
measure: Mean blood pressure
time frame: 5 min before volume loading, 5 min after volume loading
measure: Cardiac index
time frame: 5 min before volume loading, 5 min after volume loading
measure: Stroke Volume Index
time frame: 5 min before volume loading, 5 min after volume loading
measure: Airway pressures
time frame: 5 min before volume loading, 5 min after volume loading
measure: Lung Compliance
time frame: 5 min before volume loading, 5 min after volume loading
arm group label: High Frequency Positive Pressure Ventilation
arm group type: Active Comparator
arm group label: Continuous Positive Airway Pressure
arm group type: Placebo Comparator
intervention type: Procedure
intervention name: High Frequency Positive Pressure Ventilation
description: TV 2 mL kg-1 PBW, I:E ratio > 0.3, RR 60 breaths min-1 and a FGF of < 2 L min-1, using a second identical ventilator with low compliant internal circuit
arm group label: High Frequency Positive Pressure Ventilation
intervention type: Procedure
intervention name: Continuous Positive Airway Pressure
description: CPAP of 2 cm H2O
arm group label: Continuous Positive Airway Pressure
criteria: 
gender: All
minimum age: 18 Years
maximum age: 70 Years
healthy volunteers: No
last name: Abdulmohsen A Al Ghamdi, MD
role: Study Chair
affiliation: Chairman of Anesthesiology Dept
last name: Mohamed R El Tahan, MD
role: Principal Investigator
affiliation: Imam Abdulrahman Bin Faisal University
last name: Mohamed R El Tahan, MD
phone: +966 13 865 1193
email: mohamedrefaateltahan@yahoo.com
last name: Abdulmohsin A Al Ghamdi, MD
phone: +966 50 581 4737
email: mohsenkfu@hotmail.com
facility: 
contact: 
investigator: 
investigator: 
country: Saudi Arabia
responsible party type: Sponsor
mesh term: Lung Diseases