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PEEP Strategies and Mechanical Power in Robotic Surgery

ConditionsPostoperative Pulmonary ComplicationsImpaired OxygenationMechanical Ventilation
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorAnkara City Hospital Bilkent

About this trial

Robotic surgery requires pneumoperitoneum and steep Trendelenburg positioning, which significantly impair respiratory mechanics and increase the risk of postoperative pulmonary complications.

Positive end-expiratory pressure (PEEP) is a key determinant of lung recruitment; however, fixed PEEP strategies may not be optimal for all patients. Individualized PEEP titration strategies, including incremental and decremental approaches, may better optimize lung mechanics.

This randomized controlled trial aims to compare the effects of incremental, decremental, and fixed PEEP strategies on cumulative mechanical power (MP-AUC) and postoperative oxygenation in patients undergoing robotic surgery.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Age>= 18

ASA I-III

Elective robotic surgery

Disqualifiers

COPD GOLD ≥2

Restrictive lung disease

BMI >40 kg/m²

Heart failure

Trial design

Design model

Parallel

Treatments tested in this trial

  • Fixed PEEP Ventilation

    Procedure/Surgery

    Patients receive mechanical ventilation with a constant positive end-expiratory pressure (PEEP) of 5 cmH₂O throughout the surgical procedure.

  • Decremental PEEP Strategy

    Procedure/Surgery

    PEEP is gradually decreased from a higher level to determine the optimal PEEP associated with the lowest driving pressure or lowest mechanical power, and this level is maintained during surgery.

  • Incremental PEEP Strategy

    Procedure/Surgery

    PEEP is gradually increased from a lower level to identify the optimal PEEP corresponding to the lowest driving pressure or mechanical power, and this level is maintained during surgery.

Treatment groups

120 Participants
are divided into 3 treatment groups
Group A: Fixed PEEPActive comparator 3 interventions
Group B: Decremental PEEPExperimental treatment 3 interventions
Group C: Incremental PEEPExperimental treatment 3 interventions

Trial outcomes

Primary outcomes

1

Cumulative Mechanical Power (MP-AUC)

Total energy delivered to the respiratory system during surgery

Time frame
During surgery (from intubation to extubation)

Secondary outcomes

1

PaO₂/FiO₂ ratio

Time frame
Intraoperative period and postoperative period (within 2 hours)
2

Oxygenation Index (OSI)

Time frame
Postoperative 2 hours
3

Postoperative Pulmonary Complications (PPC)

Time frame
Within 7 postoperative days

Other outcomes

Locations

This trial has no locations.

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Ankara City Hospital Bilkent

Lead sponsor

Source ClinicalTrials.gov

This trial is not recruiting at the moment. You can still explore other options: