Comparison of 5 vs 8 cmH₂O PEEP on Respiratory Mechanics in Prone Lumbar Surgery
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-65
SponsorHarran University
About this trial
This randomized controlled clinical trial aims to compare the effects of two different positive end-expiratory pressure (PEEP) levels (5 cmH₂O and 8 cmH₂O) on respiratory mechanics in patients undergoing lumbar spine surgery in the prone position under total intravenous anesthesia (TIVA). Prone positioning may adversely affect lung compliance and gas exchange, making optimal ventilatory strategies essential. Driving pressure and mechanical power are considered key determinants of ventilator-induced lung stress. This study will evaluate the impact of different PEEP levels on respiratory parameters and intraoperative physiological changes.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Patients aged between 18 and 65 years
American Society of Anesthesiologists (ASA) physical status I-II
Scheduled for elective lumbar spine surgery in the prone position
Planned general anesthesia with total intravenous anesthesia (TIVA)
Disqualifiers
Body mass index (BMI) ≥ 30 kg/m²
History of significant pulmonary disease (e.g., COPD, asthma)
Severe cardiovascular disease
Pregnancy
Trial design
Design model
Parallel
Treatments tested in this trial
Mechanical Ventilation (PEEP)
DeviceMechanical ventilation will be applied using pressure-controlled ventilation with volume guarantee (PCV-VG) mode during prone lumbar surgery under total intravenous anesthesia (TIVA). Two different positive end-expiratory pressure (PEEP) levels (5 cmH₂O and 8 cmH₂O) will be used according to group allocation. Tidal volume will be set at 6-8 mL/kg predicted body weight, and respiratory rate will be adjusted to maintain normocapnia (EtCO₂ 35-40 mmHg).
Treatment groups
60 Participants
are divided into 2 treatment groupsGroup A: PEEP-5 GroupExperimental treatment 1 intervention
Group B: PEEP-8 GroupExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Driving Pressure (ΔP)
Driving pressure (ΔP), calculated as the difference between plateau pressure (Pplat) and positive end-expiratory pressure (PEEP), will be used as the primary outcome to assess lung stress during mechanical ventilation.
Time frame
Intraoperative period (at predefined time points: T0, T2, T5)Secondary outcomes
1
Mechanical Power
Mechanical power will be calculated to quantify the energy delivered to the respiratory system during mechanical ventilation.
Time frame
Intraoperative period (T0, T2, T5)2
Oxygenation (PaO₂/FiO₂ Ratio)
Oxygenation status will be assessed using the arterial oxygen partial pressure to inspired oxygen fraction (PaO₂/FiO₂) ratio.
Time frame
Intraoperative period (T0, T2, T5)3
PaCO₂-EtCO₂ Gradient
The difference between arterial carbon dioxide pressure (PaCO₂) and end-tidal CO₂ (EtCO₂) will be used to evaluate ventilation-perfusion mismatch.
Time frame
Intraoperative period (T0, T2, T5)4
Physiological Dead Space Fraction (VD/VT)
Physiological dead space fraction will be calculated using the Bohr equation to assess ventilation efficiency.
Time frame
Intraoperative period (T0, T2, T5)Locations
Sponsors and contacts
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Source ClinicalTrials.gov
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