Comparison of Hemodynamic and Pulmonary Outcomes Between Single-Step and Stepwise Lung Recruitment Maneuvers After Cardiopulmonary Bypass: A Randomized Controlled Trial

What this Trial Is About

This research aims to compare the effects on heart and lung function of two different lung recruitment methods in adults undergoing planned heart surgery with cardiopulmonary bypass. The study focuses on how these methods influence cardiac output and lung aeration after surgery, as lung complications often arise due to surgery-related factors like lung injury and inflammation. The goal is to find the best recruitment technique that improves lungs without harming heart function in this high-risk group. Participants will be randomly assigned after heart-lung machine separation to receive either a single-step sustained inflation lung recruitment maneuver or a stepwise incremental recruitment maneuver. Both methods are combined with a constant positive pressure to keep airways open. The single-step involves holding a set airway pressure for 30 seconds, while the stepwise gradually increases and then decreases airway pressure in stages. These maneuvers occur during the surgery's intraoperative period. Throughout the study, heart and lung function will be closely monitored before and after the lung recruitment. Measurements include cardiac index, heart rate, blood pressure, lung ultrasound scores, blood gases, and various lung mechanics parameters. Participants' recovery times, such as time to breathing tube removal and ICU stay length, will also be recorded. Monitoring continues into the first day after surgery to capture ongoing effects and safety outcomes.

Single-step vs Stepwise Lung Recruitment Maneuvers After Cardiopulmonary Bypass