High PEEP Application Following Pulmonary Thromboendarterectomy; Does it Have Any Impact on Outcome?

Prospective Randomized Trial of Impact of High PEEP Application Following Pulmonary Endarterectomy on Outcome

Investigation of the effect of intraoperative lung protection high PEEP maneuver on ischemic reperfusion injury in patients undergoing pulmonary endarterectomy.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease characterized by progression of thromboembolism obstructing pulmonary arteries as an organized tissue. Pulmonary thromboendarterectomy (PTE) is a treatment option for chronic thromboembolic pulmonary disease. However, PTE is associated with specific postoperative complications, such as pulmonary edema and right ventricular failure due to reperfusion injury, with a significant mortality rate of 7% to 24%. Some strategies have been proposed to reduce lung injury after PTE, such as rectification maneuvers and high PEEP. The aim of this study was to investigate the effect of intraoperative lung protection high PEEP maneuver in patients undergoing pulmonary endarterectomy for ischemic reperfusion injury.

Inclusion Criteria:

• Patients undergoing elective PTE operation due to CTEPH,
• 20-70 years old

Exclusion Criteria:

• Patients with chronic inflammatory disease,
• liver and renal failure,
• heart failure (<EF: 40%),
• intraoperative bronchial hemorrhage,
• patients undergoing postoperative revision.