Personalized Lung Volume Optimization Maneuver to Improve Lung and Heart Function in Mechanically Ventilated Children Undergoing Cardiac Surgery or With Severe Respiratory Failure

What this Trial Is About

Researchers are investigating whether a standardized lung volume optimization maneuver LVOM can improve lung function and heart performance in children. This study focuses on two groups children undergoing heart surgery with cardiopulmonary bypass for congenital heart disease, and children with severe respiratory failure who are at risk of or require extracorporeal membrane oxygenation ECMO. The research aims to see if optimizing lung volume affects breathing support duration, lung function, and heart stability among these patients. The trial compares two approaches one group receives standard care with set positive end-expiratory pressure PEEP levels and no personalized adjustments, while the other undergoes LVOM with PEEP titration to find the best lung volume settings based on lung mechanics. In children after heart surgery, PEEP levels between 10-20 cmH2O are adjusted to improve lung compliance, while in children with respiratory failure, titration is tailored during mechanical ventilation or high-frequency oscillatory ventilation. Both groups are monitored during and after these interventions. Participants will undergo various assessments including heart function, lung mechanics, lung aeration, blood oxygenation, and ventilation-perfusion matching using imaging and physiological measurements. Researchers will track outcomes such as cardiac index and ECMO duration, as well as lung performance and hemodynamic stability. The study involves regular monitoring during the perioperative and periprocedural periods to evaluate the benefits of the lung volume optimization maneuver. The trial is expected to continue until December 2027.

Influence of Personalized Lung Volume Optimization Maneuver on Lung Function and Cardiac Performance in Children