Driving Pressure During General Anesthesia for Open Abdominal Surgery (DESIGNATION)

  • End date
    Mar 11, 2023
  • participants needed
  • sponsor
    Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Updated on 11 March 2022


The purpose of this international multicenter, patient and outcome-assessor blinded randomized controlled trial is to determine whether the application of an individualized high PEEP strategy, aiming at avoiding an increase in the driving pressure during intraoperative ventilation, protects against the development of postoperative pulmonary complications.

Condition Postoperative Respiratory Complication
Treatment Individualized high PEEP strategy
Clinical Study IdentifierNCT03884543
SponsorAcademisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Last Modified on11 March 2022


Yes No Not Sure

Inclusion Criteria

Scheduled for open abdominal surgery
High or intermediate risk for postoperative pulmonary complications according to ARISCAT score [J.Canet et al, Anesthesiology 2010;113]
General anesthesia

Exclusion Criteria

Laparoscopic surgery
Surgery in prone or lateral position
Combined procedure with open abdominal and intrathoracic surgery
Body mass index > 40 kg/m2
Reported pregnancy
Mechanical ventilation > than 30 minutes (e.g., in cases of general anesthesia because of surgery) within last 30 days
Any major previous lung surgery
History of previous severe chronic obstructive pulmonary disease (COPD) GOLD III or IV, or with (noninvasive) ventilation and/or oxygen therapy at home
(previous) acute respiratory distress syndrome (ARDS)
Expected to require postoperative mechanical ventilation
Persistent hemodynamic instability or intractable shock
Severe cardiac disease (New York Heart Association class III or IV, or acute coronary syndrome, or persistent ventricular tachyarrhythmia's)
Consented for another interventional study during anesthesia or refusal to participate in the study
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