Driving Pressure-guided PEEP Titration in Robot-assisted Laparoscopic Surgeries

Seoul National University Hospital66 enrolled

Overview

The purpose of this study is to investigate the effect of driving-pressure guided positive end-expiratory pressure (PEEP) titration.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Conditions

Atelectasis, Postoperative Pulmonary

Interventions

Titrated PEEP based on driving pressurePROCEDURE

Alveolar recruitment and PEEP titration is performed at three time points: after intubation, after Trendelenburg, and after supine after CO2 deflation. The level of PEEP which makes the driving pressure lowest is selected and applied during the operation.

Conventional PEEPPROCEDURE

Alveolar recruitment is performed at three time points: after intubation, after Trendelenburg, and after supine after CO2 deflation. Conventional PEEP (5cmH2O) is applied during the operation.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients undergoing robot-assisted laparoscopic prostatectomy with Trendelenburg position Exclusion Criteria: * American Society of Anesthesiologists physical status IV or more * Severe cardiovascular disease * Severe chronic obstructive pulmonary disease, emphysema * History of pneumothorax, bullae * History of lung resection surgery * Conversion to laparotomy * Refusal to participate

Locations (1)

Seoul National University Hospital

Seoul, Jongnogu, South Korea

Outcomes

Primary Outcomes

Modified lung ultrasound score

The score is calculated by adding up the 12 individual part scores assessed using lung ultrasound. The score for each part ranges from 0 to 3.

Time frame: 30 minutes after PACU administration

Secondary Outcomes

Modified lung ultrasound score

The score is calculated by adding up the 12 individual part scores assessed using lung ultrasound. The score for each part ranges from 0 to 3.

Time frame: Intraoperative (at the end of operation before emergence)

Incidence of intraoperative desaturation

Oxygen saturation by pulse oximetry\< 95%

Time frame: Intraoperative

Intraoperative partial pressure of arterial oxygen/fraction of inspired oxygen ratio

Partial pressure of arterial oxygen/fraction of inspired oxygen ratio

Time frame: Intraoperative (30 minutes after designated PEEP applied)

Postoperative partial pressure of arterial oxygen/fraction of inspired oxygen ratio

Partial pressure of arterial oxygen/fraction of inspired oxygen ratio

Time frame: 30 minutes after PACU administration

Postoperative pulmonary complications

Extubation failure, Fever, respiratory infection, respiratory failure, pleural effusion, atelectasis, pneumothorax, bronchospasm, aspiration pneumonitis, pneumonia

Time frame: After operation~ postoperative day 3

Data from ClinicalTrials.gov

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