Blood carbon monoxide and inflammation/cell-protection markers during low-flow versus normal-flow inhaled anesthesia

The Effect of Blood Carboxyhemoglobin Levels on NF-kB, NRF2 and PGC-1α During Low-flow and Normal-flow Anesthesia

Not applicable Interventional Ataturk Training and Research Hospital · NCT07352826

This study will test whether low-flow versus normal-flow inhaled anesthesia changes blood carbon monoxide levels and related inflammation and cell-protection markers in adults having elective surgery.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment120 (estimated)
Ages18 Years to 70 Years
SexAll
SponsorAtaturk Training and Research Hospital Academic / other
Locations1 site (Erzurum)
Trial IDNCT07352826 on ClinicalTrials.gov

What this trial studies

This single-center interventional study will enroll 120 adults (18–70 years, ASA I) undergoing inhalational anesthesia lasting at least two hours and randomly receive low-flow or normal-flow techniques. Blood samples will be taken preoperatively and processed for carboxyhemoglobin (COHb) and plasma levels of NF-κB, NRF2, and PGC-1α, with sera stored at −80 °C and blood gases measured on a clinical analyzer. Patients with cardiovascular, respiratory, hepatic, or renal disease, smokers, pregnant or breastfeeding women, emergency or trauma cases, and those needing intraoperative transfusion are excluded. The study aims to correlate COHb with markers of inflammation and anti-apoptotic/protective pathways to see if low-flow anesthesia alters these biomarker profiles.

Who should consider this trial

Good fit: Adults aged 18–70 years in good health (ASA I) scheduled for elective inhalational anesthesia lasting two hours or longer are ideal candidates.

Not a fit: Patients with cardiovascular, respiratory, hepatic, or renal disease, smokers, pregnant or breastfeeding women, emergency/trauma cases, or those needing transfusion are excluded and would not benefit from participation.

Why it matters

Potential benefit: If successful, the findings could clarify whether low-flow anesthesia alters protective or inflammatory pathways and help refine anesthesia approaches to reduce perioperative cellular stress.

How similar studies have performed: Preclinical and some clinical work suggest low levels of carbon monoxide can modulate inflammatory and protective pathways, but clinical data specifically relating COHb to NF-κB, NRF2, and PGC-1α during anesthesia are limited.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

aged 18-70 years

classified as ASA I

scheduled for inhalational anesthesia lasting ≥2 hours

Exclusion Criteria:

Patients with cardiovascular disease, respiratory system disease, hepatic or renal disease

pregnant or breastfeeding women

trauma patients

those undergoing emergency surgery

procedures lasting \<2 hours

those receiving intraoperative blood transfusion

smokers

individuals who decline participation

Where this trial is running

Erzurum

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Anesthesialow flow anesthesiaCOHbNF-kBNRF2PGC-1 alpha
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.