Effect of Individualized PEEP on Postoperative Pulmonary Complication in Bariatrics

Ain Shams University

Status: Enrolling

Conditions: Mechanical Ventilation Pressure High; Bariatric Surgery Candidate

Treatments: Other: titated PEEP to best static compliance

Study type: Interventional

Funder types: Other

Identifiers

NCT06168162

FMASU MD259/2023

Details and patient eligibility

About

Ventilation with low tidal volume and high PEEP (positive end expiratory pressure) has been shown to improve oxygenation in patients with ARDS (acute respiratory distress syndrome). In obese patients undergoing laparoscopic bariatric surgeries, the risk of postoperative pulmonary complications (PPCs) increases significantly with general anesthesia. Previous studies have shown that protective lung ventilation strategies could improve intraoperative oxygenation and lung mechanics.

In this study would compare the effect of optimum individualized high PEEP versus standard PEEP - on postoperative pulmonary complications

Enrollment: 50 estimated patients

Sex: All

Ages: 16+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients were eligible for participation if the met the following criteria

  • Age between 18 and 60 years old.
  • Body mass index > 40
  • Laparoscopic bariatric elective surgery under general anesthesia.
  • ARISCAT (Assess Respiratory Risk in Surgical Patients in Catalonia) score ≥ 45 . ARISCAT score is a clinically practical seven-factor scoring system to assess the risk of a composite PPC.

Exclusion criteria

• Previous lung surgery
• ASA status III or IV.
• Moderate to severe obstructive or restrictive lung disease .
• Persistant intraoperative hemodynamic instability .
• Need for postoperative mechanical ventilation

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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50 participants in 2 patient groups

titrate PEEP

Experimental group

Description:

individulaized PEEP starting 7cmH2O titrated to best static compliance (Cstat) ranging from 50 -100 cmH2O

Treatment:

Other: titated PEEP to best static compliance

standard

Active Comparator group

Description:

standard PEEP of 5 cmH2O

Treatment:

Other: titated PEEP to best static compliance