Respiratory and Hemodynamic Targets During General Anesthesia

Respiratory and Hemodynamic Targets During General Anesthesia - A Randomized Clinical Trial

This trial is an investigator-initiated, multicenter, randomized, factorial, single-blind trial of multiple hemodynamic and respiratory targets during general anesthesia. These targets include blood pressure, positive end expiratory pressure, tidal volume, and fraction of inspired oxygen. Patients will be randomized to different targets using a factorial design, i.e., each patient is simultaneously randomized to four interventions. There will be five enrolling sites in the Central Denmark Region. 480 high-risk patients will be enrolled.

Inclusion Criteria:

• Age ≥ 18 years
• American Society of Anesthesiologists (ASA) classification 3 to 5
• Planned endotracheal intubation with positive pressure ventilation
• Expected operating time ≥ 90 minutes
• Certain types of surgery

Exclusion Criteria:

• Inability to obtain consent (e.g., patient is unconscious, hyperacute surgery)
• Known or suspected pregnancy
• Out-patient/same-day surgery
• Intubated prior to surgery
• Clinical judgement by the anesthesiologist that any of the interventions could be potentially harmful to the patient