PEEP Strategies and Mechanical Power in Robotic Surgery
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: Fixed PEEP Ventilation, Decremental PEEP Strategy, Incremental PEEP Strategy.
- Who it may be relevant to
- Registry conditions: Postoperative Pulmonary Complications, Impaired Oxygenation, Mechanical Ventilation. 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
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Comparison of Incremental, Decremental, and Fixed PEEP Strategies on Mechanical Power and Postoperative Oxygenation in Robotic Surgery: A Prospective Randomized Controlled Trial
Overview
Robotic surgery requires pneumoperitoneum and steep Trendelenburg positioning, which significantly impair respiratory mechanics and increase the risk of postoperative pulmonary complications. Positive end-expiratory pressure (PEEP) is a key determinant of lung recruitment; however, fixed PEEP strategies may not be optimal for all patients. Individualized PEEP titration strategies, including incremental and decremental approaches, may better optimize lung mechanics. This randomized controlled trial aims to compare the effects of incremental, decremental, and fixed PEEP strategies on cumulative mechanical power (MP-AUC) and postoperative oxygenation in patients undergoing robotic surgery.
Interventions
- Procedure Fixed PEEP Ventilation
Patients receive mechanical ventilation with a constant positive end-expiratory pressure (PEEP) of 5 cmH₂O throughout the surgical procedure. - Procedure Decremental PEEP Strategy
PEEP is gradually decreased from a higher level to determine the optimal PEEP associated with the lowest driving pressure or lowest mechanical power, and this level is maintained during surgery. - Procedure Incremental PEEP Strategy
PEEP is gradually increased from a lower level to identify the optimal PEEP corresponding to the lowest driving pressure or mechanical power, and this level is maintained during surgery.
Primary outcome measures
- Cumulative Mechanical Power (MP-AUC) [Time frame: During surgery (from intubation to extubation)]
Secondary outcome measures (3)
- PaO₂/FiO₂ ratio [Time frame: Intraoperative period and postoperative period (within 2 hours)]
- Oxygenation Index (OSI) [Time frame: Postoperative 2 hours]
- Postoperative Pulmonary Complications (PPC) [Time frame: Within 7 postoperative days]
Eligibility criteria
Inclusion criteria
- Age>= 18
- ASA I-III
- Elective robotic surgery
Exclusion criteria
- COPD GOLD ≥2
- Restrictive lung disease
- BMI >40 kg/m²
- Heart failure
- Preoperative oxygen requirement
- Need for postoperative mechanical ventilation
- Refusal to participate
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07536464 · E26-14833