Driving Pressure Guided Mechanical Ventilation Versus Lung Protective Ventilation Among Patients Undergoing Elective Surgeries
A Comparison of Driving Pressure Guided Mechanical Ventilation With Lung Protective Ventilation Among Patients Presenting for Elective Surgeries at a Tertiary Care Hospital; A Randomized Control Trial
Rawalpindi Medical College
70 participants
Jul 20, 2025
INTERVENTIONAL
Conditions
Summary
Patient undergoing surgeries in general anesthesia require support of their breathing by ventilator. Different strategies can be used to manage breathing of the patient. Lung protective ventilation provides breathing at a set volume determined by patient ideal body weight, along with a set rate to maintain adequate breathing. The pressures in the lower airway are kept less than 30 cm of H20 while a pressure of 5cm of H20 is applied to prevent lung collapse. Recently to above mentioned regimen a driving pressure is added which is a difference between lower airway pressure and pressure applied to prevent lung collapse. Ventilatory settings are adjusted to keep this driving pressure less than 15 cm of H2O.
Eligibility
Inclusion Criteria4
- American Society of Anesthesiologists (ASA) class: I and II.
- Elective laparoscopic surgeries requiring General Anesthesia and Mechanical ventilation
- Patients receiving neuromuscular blockade during surgery.
- Receiving Mechanical ventilation for at least 1h.
Exclusion Criteria5
- Pregnancy
- Patients who had received mechanical ventilation of more than 1h in the previous 2 weeks.
- Body mass index >35 kg/m2
- Smokers and ASA class III and above.
- Thoracic and Cardiac surgery
Interested in this trial?
Get notified about updates and connect with the research team.
Interventions
The patient in this group will receive tidal volume at 6-8 ml/kg of ideal body weight with PEEP of 5 cm of H2O and plateau pressure will be kept less than 30cm of H2O.
They will receive tidal volume of 6-8 ml/kg of ideal body weight and initial PEEP of 5 cm of water. Principal investigator will then incrementally increase PEEP by 2 cm of water till a value 15 cm of water PEEP is reached or Plateau pressure becomes equal to 30 cm of water or driving pressure starts to increase or there is change in any hemodynamics. Each incremental PEEP will last for 3 respiratory cycles before moving on to next value. PEEP value with lowest driving pressure will then be selected for the duration of surgical procedure
Locations(1)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT07092943