Driving-pressure guided ventilation versus lung-protective ventilation during elective laparoscopic surgery
A Comparison of Driving Pressure Guided Mechanical Ventilation With Lung Protective Ventilation Among Patients Presenting for Elective Surgeries at a Tertiary Care Hospital; A Randomized Control Trial
We will test if adjusting the ventilator to keep the driving pressure under 15 cm H2O helps adults having elective laparoscopic surgery breathe better while under general anesthesia.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 70 (estimated) |
| Ages | 16 Years to 80 Years |
| Sex | All |
| Sponsor | Rawalpindi Medical College Academic / other |
| Locations | 1 site (Rawalpindi, Punjab Province) |
| Trial ID | NCT07092943 on ClinicalTrials.gov |
What this trial studies
Adults undergoing elective laparoscopic surgery under general anesthesia and neuromuscular blockade are assigned to receive either standard lung-protective ventilation (tidal volumes 6–8 ml/kg ideal body weight, PEEP ~5 cm H2O, plateau pressure <30 cm H2O) or a driving-pressure guided strategy where PEEP is adjusted to keep the difference between plateau pressure and PEEP (driving pressure) ≤15 cm H2O. Ventilation is continued for the duration of the operation when mechanical ventilation is required for at least one hour. The protocol focuses on intraoperative ventilator settings and monitors airway pressures and standard respiratory parameters. Outcomes include intraoperative lung mechanics and markers of postoperative pulmonary complications and safety events.
Who should consider this trial
Good fit: Ideal candidates are adults classified ASA I–II having elective laparoscopic surgery under general anesthesia with neuromuscular blockade who will need mechanical ventilation for at least one hour and have BMI ≤35 kg/m2.
Not a fit: Patients unlikely to benefit include pregnant people, those with BMI >35 kg/m2, active smokers, ASA class III or higher, recent invasive mechanical ventilation within two weeks, or those undergoing thoracic or cardiac surgery.
Why it matters
Potential benefit: If successful, this approach could reduce ventilator-related stress on the lungs during surgery and lower the risk of postoperative breathing problems.
How similar studies have performed: Some critical care studies have linked lower driving pressure with better outcomes, but using driving-pressure guidance specifically during routine elective surgery is not yet well established.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * American Society of Anesthesiologists (ASA) class: I and II. * Elective laparoscopic surgeries requiring General Anesthesia and Mechanical ventilation * Patients receiving neuromuscular blockade during surgery. * Receiving Mechanical ventilation for at least 1h. Exclusion Criteria: * Pregnancy * Patients who had received mechanical ventilation of more than 1h in the previous 2 weeks. * Body mass index \>35 kg/m2 * Smokers and ASA class III and above. * Thoracic and Cardiac surgery
Where this trial is running
Rawalpindi, Punjab Province
- Benazir Bhutto Hospital — Rawalpindi, Punjab Province, Pakistan (Recruiting)
Study contacts
- Study coordinator: Huda Tariq, MBBS
- Email: Huda8829@gmail.com
- Phone: +92-321-8829413
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.