Comparing Electrical Impedance Tomography and Dynamic Compliance Guided PEEP Titration for Lung Protection During Laparoscopic Gynecological Surgery

What this Trial Is About

Researchers are comparing two methods of setting positive end-expiratory pressure PEEP during mechanical ventilation in patients with healthy lungs undergoing laparoscopic gynecological surgery. The study evaluates whether electrical impedance tomography EIT-guided PEEP titration can better protect the lungs by reducing the mechanical power of ventilation and improving oxygen levels compared to the dynamic pulmonary compliance Cdyn-guided method. The goal is to see if EIT guidance can reduce lung injury, postoperative lung complications, and improve recovery while potentially lowering healthcare costs. Two groups will be studied one receiving PEEP titration guided by EIT and the other guided by Cdyn. PEEP will be decreased stepwise from 18 to 6 cmH2O during surgery with measurements taken at each level. The optimal PEEP is determined differently for each group based on either EIT parameters or Cdyn values. After determining optimal PEEP, lung protective ventilation with low tidal volumes will be used during surgery. Participants will be monitored during surgery and for two days after for ventilation power, oxygenation, lung function, and lung complications. Assessments include blood gas analyses, lung imaging with EIT, and clinical scoring of organ function. Mortality will be followed up to 28 days after surgery. This thorough monitoring aims to understand how each method affects lung protection and recovery after surgery.

EIT vs Dynamic Compliance Guided PEEP Titration During Laparoscopic Gynecological Surgery