RecruitingNot ApplicableNCT06181279

Effects of Individualized PEEP Guided by Driving Pressure on Postoperative Atelectasis in Patients With Morbid Obesity

Effects of Individualized Positive End-expiratory Pressure Guided by Driving Pressure on Postoperative Atelectasis After Bariatric Surgery in Patients With Morbid Obesity: A Single-center, Prospective, Randomized Controlled Study

Sponsor

Yongtao Sun

Enrollment

52 participants

Start Date

Mar 1, 2024

Study Type

INTERVENTIONAL

Conditions

pulmonary atelectasis,Obesity, Morbid

Summary

Atelectasis is a common complication in patients undergoing surgery under general anesthesia, particularly in obese patients. Postoperative atelectasis could last for more than 24h and contribute to a variety of other complications, including hypoxemia and pneumonia. We plan to conduct a single-center, randomized controlled trial in patients undergoing bariatric surgery to test the hypothesis that driving pressure guided PEEP could reduce the postoperative atelectasis.

Eligibility

Min Age: 18 YearsMax Age: 60 Years

Plain Language Summary

Simplified for easier understanding

This study examines whether adjusting the level of PEEP (positive end-expiratory pressure — a breathing support setting used during surgery) based on each patient's individual lung mechanics can reduce the risk of collapsed lung tissue (atelectasis) after bariatric surgery. Atelectasis is a common surgical complication in obese patients that can cause low oxygen levels and lung infections. Adults aged 18 to 60 with a BMI of 40 or above (morbid obesity) who are scheduled for bariatric surgery may be eligible, excluding those with recent respiratory infections or serious cardiac or kidney disease. Participation involves receiving personalized ventilator settings during surgery and undergoing imaging assessments to check lung status after the procedure. This summary was generated with AI assistance to help patients understand the study in plain language.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

PROCEDUREIndividualized PEEP group

Individualized PEEP group: Recruitment Maneuver (RM) is performed first. In pressure control mode, PEEP and airway plateau pressure are increased to 20 cmH2O and 35 cmH2O at a rate of 5 cmH2O every 30s, and driving pressure is maintained at 15 cmH2O throughout. Subsequently, in volume-controlled ventilation mode, PEEP decreases from 20 cmH2O to 4 cmH2O at gradient of 2 cmH2O, and each PEEP level is maintained for 30s. The PEEP corresponding to the lowest driving pressure is the individualized PEEP we need. If multiple PEEP levels showed the same lowest driving pressure, the lowest PEEP value as the individualized PEEP. The above procedures are performed three times during the surgery (5 minutes after intubation,5 minutes after the beginning of pneumoperitoneum, and 5 minutes after the end of pneumoperitoneum).

PROCEDUREFixed PEEP group

After the same RM, PEEP is fixed at 8 cmH2O.

Locations(1)

Qianfoshan Hospital, The First Hospital affiliated of Shandong First Medical University

Jinan, Shandong, China

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NCT06181279

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