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Driving Pressure-Guided Individualized PEEP Versus Standard PEEP: Effects on Postoperative Pulmonary Complications in Upper Abdominal Digestive Surgery

RecruitingNAAges 18 Years - anyAllHopital Charles Nicolle
NCT07885124 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

This randomized clinical trial compares two methods of setting positive end-expiratory pressure (PEEP) during general anesthesia in adults undergoing upper abdominal digestive surgery who are at moderate or high risk of postoperative pulmonary complications. All participants will receive lung-protective mechanical ventilation. Participants will be randomly assigned to one of two groups. In the individualized PEEP group, PEEP will be adjusted to achieve the lowest driving pressure following a lung recruitment maneuver. In the standard PEEP group, PEEP will be fixed at 5 cmH2O. The main question is whether driving pressure-guided individualized PEEP reduces the proportion of participants who develop one or more postoperative pulmonary complications during the first 7 days after surgery compared with standard PEEP.

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📋 Eligibility rules (as published)
Inclusion Criteria: * Age 18 years or older. * Scheduled for supra-mesocolic upper abdominal digestive surgery. * American Society of Anesthesiologists (ASA) physical status I, II, or stable III. * Moderate or high risk of postoperative pulmonary complications, defined by an Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score of 26 or higher. * Provision of written informed consent. Exclusion Criteria: * Refusal to participate or inability to provide written informed consent. * Pregnancy. * ASA physical status greater than III. * History of acute respiratory distress syndrome. * Pulmonary hypertension. * Bronchopleural fistula. * Chronic obstructive pulmonary disease with severe emphysema. * Pre-existing cardiac arrhythmia. * Decompensated heart failure. * Known condition associated with increased intracranial pressure. * Intra-abdominal hypertension.
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What it tests

  • Driving Pressure-Guided Individualized PEEP
  • Standard PEEP
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Where

1 site
Charles Nicole Hospital
Tunis, Tunisia
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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