Robot-assisted laparoscopic radical prostatectomy (RALP) requires steep Trendelenburg positioning and pneumoperitoneum, which adversely affect respiratory mechanics and may lead to impaired postoperative oxygenation. Mechanical power (MP) has recently emerged as a comprehensive parameter reflecting the total energy delivered from the ventilator to the respiratory system and may be associated with ventilator-induced lung injury. This prospective randomized controlled trial aims to evaluate whether a mechanical power-targeted ventilation strategy improves postoperative oxygenation compared to standard ventilation in patients undergoing RALP. The primary outcome is the oxygenation index (OSI) at the postoperative second hour. Secondary outcomes include PaO₂/FiO₂ ratio, postoperative pulmonary complications, and length of hospital stay.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
80
Ventilation adjusted to achieve the lowest possible mechanical power (≤14 J/min) using titration of PEEP and respiratory rate.
Conventional ventilation strategy with fixed PEEP (5 cmH₂O) and routine settings.
Ankara Bilkent City Hospital
Ankara, Turkey (Türkiye)
Oxygenation Index (OSI)
OSI calculation: OSI = FiO₂ × MAP × 100 / SpO₂
Time frame: postoperative 2nd hour
PaO₂/FiO₂ ratio
Time frame: Intraoperative period and postoperative 2 hours
Postoperative pulmonary complications (PPC)
Time frame: Within 7 postoperative days
Intraoperative respiratory mechanics
Dynamic compliance (Cdyn, mL/cmH₂O) Static compliance (Cstat, mL/cmH₂O) Peak airway pressure (Ppeak, cmH₂O) Plateau pressure (Pplat, cmH₂O) Driving pressure (ΔP = Pplat - PEEP, cmH₂O) Mean airway pressure (MAP, cmH₂O) Airway resistance
Time frame: During surgery (from intubation to extubation)
Mechanical power changes
Time frame: During surgery (at predefined intraoperative time points)
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