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The purpose of this study is to investigate the effect of driving-pressure guided positive end-expiratory pressure (PEEP) titration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Driving pressure | Experimental | The selected PEEP which makes the driving pressure lowest is applied during the operation. |
|
| Conventional | Active Comparator | Conventional PEEP (5cmH2O) is applied. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Titrated PEEP based on driving pressure | Procedure | Alveolar recruitment and PEEP titration is performed at three time points: after intubation, after Trendelenburg, and after supine after CO2 deflation. The level of PEEP which makes the driving pressure lowest is selected and applied during the operation. |
| Measure | Description | Time Frame |
|---|---|---|
| Modified lung ultrasound score | The score is calculated by adding up the 12 individual part scores assessed using lung ultrasound. The score for each part ranges from 0 to 3. | 30 minutes after PACU administration |
| Measure | Description | Time Frame |
|---|---|---|
| Modified lung ultrasound score | The score is calculated by adding up the 12 individual part scores assessed using lung ultrasound. The score for each part ranges from 0 to 3. | Intraoperative (at the end of operation before emergence) |
| Incidence of intraoperative desaturation |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Susie Yoon, MD | Seoul National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | Jongnogu | 03080 | South Korea |
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| ID | Term |
|---|---|
| D001261 | Pulmonary Atelectasis |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| Conventional PEEP | Procedure | Alveolar recruitment is performed at three time points: after intubation, after Trendelenburg, and after supine after CO2 deflation. Conventional PEEP (5cmH2O) is applied during the operation. |
|
Oxygen saturation by pulse oximetry< 95% |
| Intraoperative |
| Intraoperative partial pressure of arterial oxygen/fraction of inspired oxygen ratio | Partial pressure of arterial oxygen/fraction of inspired oxygen ratio | Intraoperative (30 minutes after designated PEEP applied) |
| Postoperative partial pressure of arterial oxygen/fraction of inspired oxygen ratio | Partial pressure of arterial oxygen/fraction of inspired oxygen ratio | 30 minutes after PACU administration |
| Postoperative pulmonary complications | Extubation failure, Fever, respiratory infection, respiratory failure, pleural effusion, atelectasis, pneumothorax, bronchospasm, aspiration pneumonitis, pneumonia | After operation~ postoperative day 3 |