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

Last updated: June 1, 2024
Sponsor: Yongtao Sun
Overall Status: Active - Recruiting

Phase

N/A

Condition

Obesity

Diabetes Prevention

Treatment

Fixed PEEP group

Individualized PEEP group

Clinical Study ID

NCT06181279
DP guided PEEP
  • Ages 18-60
  • All Genders

Study 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 Criteria

Inclusion

Inclusion Criteria:

  • Age 18 to 60 years old;

  • Body mass index (BMI) ≥ 40 kg/m2;

  • ASA classification I to III;

  • Signing the informed consent form for this clinical study;

Exclusion

Exclusion Criteria:

  • Respiratory infection within 4 weeks; severe respiratory system diseases; history ofpulmonary and/or thoracic surgery; neuromuscular dysfunction;

  • Serious cardiac, renal or haematopoietic diseases;

  • Contraindications to PEEP；

Study Design

Total Participants: 52
Treatment Group(s): 2
Primary Treatment: Fixed PEEP group
Phase:
Study Start date:
March 01, 2024
Estimated Completion Date:
December 31, 2024

Study Description

Positive end-expiratory pressure (PEEP) is a strategy that helps to keep alveoli open during surgery and to prevent postoperative atelectasis. A fixed PEEP without considering the respiratory mechanics in individual patients, however, is not optimal. Individualized PEEP therefore has been increasingly studied, and has been shown to improve oxygenation in both nonobese and obese patients. Studies have shown that the occurrence and prognosis of PPCs are significantly associated with high driving pressure (DP), but not with VT and PEEP. Driving pressure-guided individualized PEEP is expected to be a novel perioperative lung protection strategy. Consequently, the main aim of this study is to investigate the effect of a driving pressure-guided individualized PEEP ventilation strategy on postoperative pulmonary atelectasis in morbidly obese patients undergoing bariatric surgery.

Connect with a study center

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

    Jinan, Shandong 250014
    China

    Active - Recruiting

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