Effect of Mechanical Power-based Lung-protective Ventilation During One-lung Ventilation

Incidence of Postoperative Pulmonary Complications Between Mechanical Power-based Versus Conventional Lung Protective Ventilation During One-lung Ventilation: a Randomized Controlled Trial

The goal of this clinical trial is to determine whether a mechanical power-based lung-protective ventilation strategy during one-lung ventilation reduces the incidence of postoperative pulmonary complications in adult patients undergoing lung resection surgery.

Mechanical power during pressure-regulated volume control mode is calculated using the formula below.

Mechanical power (J/min) = 0.098 x respiratory rate x tidal volume x (inspiratory airway pressure above positive end-expiratory pressure + positive end-expiratory pressure)

The main questions it aims to answer are:

• Does a mechanical power-based lung-protective ventilation strategy significantly lower the incidence of major postoperative pulmonary complications compared to conventional ventilation?
• How does this strategy impact intraoperative hemodynamic and vital profiles (e.g., blood pressure, cardiac output, vasopressor requirements, and blood oxygen saturation) during one-lung ventilation?

Participants will:

• Be randomized to receive either a mechanical power-based lung-protective ventilation strategy or a conventional lung-protective ventilation strategy exclusively during one-lung ventilation.
• Be closely monitored for the occurrence of major postoperative pulmonary complications (atelectasis, pneumonia, acute respiratory distress syndrome, and pulmonary aspiration) and adverse events for 1 month postoperatively.

Inclusion Criteria

• American Society of Anesthesiologists (ASA) physical status I-III
• Elective thoracic surgery requiring lung lobectomy under one-lung ventilation
• Age 18 years or older
• Written informed consent obtained from the patient

Exclusion Criteria

• Prior history of thoracic surgery
• Emergency surgery
• Pregnancy or lactation
• Known contraindication to one-lung ventilation
• Inability to provide informed consent or cooperate with the study protocol