Mechanical Power and Driving Pressure Exposure in Laparoscopic Surgery

N/ANot Yet RecruitingNCT07431242

Istinye University90 enrolled

Overview

Postoperative pulmonary complications (PPCs) remain an important cause of morbidity after abdominal surgery. Intraoperative mechanical ventilation may contribute to lung injury through the mechanical load applied to the respiratory system. Mechanical power (MP) and driving pressure (DP) have emerged as integrative parameters reflecting the total ventilatory burden delivered to the lungs. This prospective observational study aims to evaluate the association between time-dependent exposure to intraoperative mechanical power and driving pressure and postoperative pulmonary outcomes in patients undergoing elective laparoscopic abdominal surgery. Ventilatory parameters will be recorded at predefined intervals during routine clinical care, and MP and DP will be calculated without altering clinical management. The primary objective is to assess whether longer exposure to elevated ventilatory load is associated with the development of postoperative pulmonary complications.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Postoperative Pulmonary Complications

Interventions

Intraoperative Ventilatory Load Exposure (Mechanical Power and Driving Pressure)

Intraoperative ventilatory load exposure is defined as the time-dependent exposure to calculated mechanical power (MP) and driving pressure (DP) values recorded during routine volume-controlled mechanical ventilation. No protocol-driven modification of ventilatory settings will be performed. Mechanical power and driving pressure will be calculated from standard ventilator parameters obtained during routine clinical care, and exposure duration above predefined threshold values will be analyzed in relation to postoperative pulmonary outcomes.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥ 18 years * Scheduled for elective laparoscopic abdominal surgery under general anesthesia * Intraoperative mechanical ventilation with volume-controlled ventilation * Provision of written informed consent Exclusion Criteria: * Emergency surgery * Conversion to open surgery * Preoperative invasive or noninvasive mechanical ventilation * Intraoperative major complications requiring substantial deviation from routine ventilation management * Incomplete intraoperative or postoperative data * Refusal or inability to provide informed consent

Outcomes

Primary Outcomes

Postoperative Pulmonary Complications (PPCs)

Occurrence of postoperative pulmonary complications within the early postoperative period, including prolonged oxygen requirement, hypoxemia (SpO₂ \< 92% on room air), need for non-invasive ventilation, or reintubation. PPC will be recorded as a composite binary outcome (present/absent).

Time frame: Within 72 hours after surgery