Study on Driving Pressure-guided Lung Protective Ventilation to Prevent Low Oxygen Levels After Surgery for Acute Type A Aortic Dissection

What this Trial Is About

This research aims to evaluate whether a lung ventilation method guided by driving pressure can reduce the occurrence of low oxygen levels after surgery in patients who have had emergency repair for acute type A aortic dissection. This serious condition requires urgent surgery, and many patients experience low oxygen levels after this procedure, which can lead to complications like longer time on ventilators, longer ICU stays, and higher risk of death. The study seeks to provide clearer evidence on the benefits of this ventilation approach. Participants will receive either driving pressure-guided lung protective ventilation or conventional lung protective ventilation during their surgery. The driving pressure method involves testing different positive end expiratory pressure PEEP levels in cycles after intubation to find the optimal setting that results in the lowest driving pressure. This optimal PEEP is maintained during the off-pump period. Ventilation parameters such as tidal volume, respiratory rate, and inhalationexhalation patterns are adjusted based on monitoring and patient lung condition. Management of low oxygen levels involves several steps including checking equipment, improving heart function, adjusting ventilation settings, and considering advanced support if needed. During the study, researchers will monitor oxygen levels and lung function closely for up to 7 days after surgery, along with tracking other complications, heart events, time on ventilation, and ICU stay length. Various measurements including blood oxygen levels and ventilation settings will be recorded daily, and participants will be followed for up to 30 days to assess early and late outcomes. Safety and treatment effects will be assessed throughout this period, with the primary focus on the rate of low oxygen episodes within the first week after surgery.

Driving Pressure-guided Lung Protective Ventilation