Comparing Protective Mechanical Ventilation and Minimum Driving Pressure Ventilation During High-Risk Surgeries to Prevent Lung Complications

What this Trial Is About

Researchers are evaluating two different types of perioperative mechanical ventilation MV to see which better prevents postoperative pulmonary complications PPCs in adult patients at higher risk. The study compares Protective Mechanical Ventilation PMV, a conventional method with preset lung pressures, to MV using the lowest possible Driving Pressure P tailored to individual lung mechanics. The goal is to find if MV with lower P can reduce PPCs, hospital stay length, ICU need, and mortality. Participants will be randomly assigned to one of two groups. One group receives conventional PMV with standard settings including PEEP of 8 cm H2O and tidal volume of 8 mlkg ideal body weight. The other group receives MV where PEEP is individually adjusted to minimize driving pressure after measuring lung compliance. Both groups receive mechanical ventilation with similar volumes, respiratory rates, inspired oxygen fractions, and hourly recruitment maneuvers during surgery. After surgery, participants will be monitored for PPCs such as atelectasis, respiratory failure, bronchospasm, pleural effusion, pneumonia, aspiration pneumonitis, and pneumothorax using arterial blood tests and chest X-rays. Researchers will also record hospital stay duration, ICU admission and stay, 28-day mortality, and detailed perioperative lung pressure and volume measurements. The study follows patients from the operation day through their hospital stay and up to 28 days postoperatively.

Driving Pressure During Surgeries With High Risk for Postoperative Pulmonary Complications