Effects of Individualized Positive End-expiratory Pressure Guided by Driving Pressure on Postoperative Atelectasis After Bariatric Surgery in Patients With Morbid Obesity: A Single-center, Prospective, Randomized Controlled Study

What this Trial Is About

Researchers are investigating the impact of individualized positive end-expiratory pressure (PEEP) guided by driving pressure on reducing postoperative pulmonary atelectasis in patients with morbid obesity undergoing bariatric surgery. Atelectasis is a common complication after surgery under general anesthesia, particularly in obese patients, and can lead to further issues like low oxygen levels and pneumonia. This study is a single-center, randomized controlled trial aiming to assess a novel lung protection strategy during surgery. Participants will be randomly assigned to one of two groups. In the individualized PEEP group, after a recruitment maneuver, PEEP is adjusted downwards based on driving pressure measurements to find the optimal PEEP that minimizes lung pressure, repeated three times at specific surgery stages. The fixed PEEP group receives a constant PEEP of 8 cmH2O after the same maneuver. This approach aims to compare the effectiveness of personalized lung ventilation against a standard fixed setting. During the study, measurements will be taken 30 minutes after extubation to evaluate the incidence of postoperative pulmonary atelectasis and lung ultrasound scores. Patients will be monitored throughout surgery and postoperatively to assess lung function and complications. The total participation includes surgery and immediate postoperative evaluations, with safety and lung protection outcomes carefully recorded to determine the benefit of the individualized ventilation strategy.

Effects of Individualized PEEP Guided by Driving Pressure on Postoperative Atelectasis in Patients With Morbid Obesity