Stepwise PEEP vs Sustained Inflation in Bariatric Surgery Patients
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: sustained inflation recruitement, Stepwise PEEP.
- Who it may be relevant to
- Registry conditions: Recruitment, Bariatric Surgery Candidate. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Egypt
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Comparison of Stepwise PEEP vs Sustained Inflation Recruitment Maneuvers on Postoperative Oxygenation and Atelectasis in Bariatric Surgery Patients
Overview
Male and female patients Undergoing laparoscopic bariatric surgeries will be subjected for lung recruitment at end of surgery before emergence from anesthesia by two different methods . to evaluate which might be safer and more effective
Detailed description
In the SI group:, the anesthesiologist adjust the ventilator to manual ventilation mode and ad¬just The ventilator will be switched to manual mode, and the airway pressure-limiting valve will be set to 30 cmH₂O. A sustained manual inflation was then applied by gradually squeezing the anesthesia reservoir bag over 3-5 seconds until a peak airway pressure (Ppeak) of 30 cmH₂O was achieved. This pressure was maintained continuously for 30 seconds. Following the maneuver, mechanical ventilation was resumed with positive end-expiratory pressure (PEEP) back to 5 cmho In the IP group:, alveolar recruitment will be performed as follows: ventilation will be set to pressure control mode and the driving pressure maintained at 10 cmH2O with an initial PEEP of 5 cmH2O, respiratory rate 8-10, I:E 1-1PEEP will be then increased by 5 cmH2O ev¬ery 30 s until the Ppeak reached 30 cmH2O (so peep will reach 20), held for 30 s , then PEEP will be gradually reduced at intervals of 5 cmH2O down to 5 cmH2O, when initial volume control ventilation will be resumed. In the incremental PEEP group, PEEP was increased stepwise by 5 cmH₂O every 3-5 breaths until a peak airway pressure of 30 cmH₂O was achieved, after which mechanical ventilation was resumed with maintenance PEEP. The total duration of the recruitment maneuver was approximately 60-90 seconds.
Interventions
- Procedure sustained inflation recruitement
anesthesiologist adjust the ventilator to manual ventilation mode and ad¬just The ventilator was switched to manual mode, and the airway pressure-limiting valve was set to 30 cmH₂O. A sustained manual inflation was then applied by gradually squeezing the anesthesia reservoir bag over 3-5 seconds until a peak airway pressure (Ppeak) of 30 cmH₂O - Procedure Stepwise PEEP
: ventilation will be set to pressure control mode and the driving pressure maintained at 10 cmH2O with an initial PEEP of 5 cmH2O, respiratory rate 8-10, I:E 1-1PEEP will be then increased by 5 cmH2O ev¬ery 30 s until the Ppeak reached 30 cmH2O
Primary outcome measures
- Postoperative lung aeration [Time frame: in the post-anesthesia care unit 15 minutes after extubation]
Secondary outcome measures (2)
- Postoperative oxygenation [Time frame: in the post-anesthesia care unit 15 minutes after extubation]
- Oxygen requirement in PACU [Time frame: in the post-anesthesia care unit 15 minutes after extubation]
Eligibility criteria
Inclusion criteria
- Anesthesiologists (ASA) physical status II, of either sex Age ≥18 y.
- Undergoing laparoscopic bariatric surgeries; sleeve gastrectomy, mini gastric bypass
- BMI (35-60)
Exclusion criteria
- Pre-existing severe pulmonary disease
- Baseline hypoxemia SpO₂ <92% on room air
- History of barotrauma
- Previous pneumothorax
- Known pulmonary bullae or emphysematous blebs
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Prevention
Study locations
Egypt · 1 center
- Ain Shams university hospitals — Cairo
Identifiers
NCT: NCT07525232 · FMASU R58/2026