EIT versus dynamic compliance guidance for setting PEEP during laparoscopic gynecological surgery
Electrical Impedance Tomography vs Dynamic Compliance Guided Positive End-expiratory Pressure Titration During Laparoscopic Gynecological Surgery: A Multi-center, Prospective Randomized Trial - TITRANT
This trial tests whether using electrical impedance tomography (EIT) to set PEEP works better than using dynamic lung compliance for adults having elective laparoscopic gynecological surgery.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 200 (estimated) |
| Ages | 18 Years and up |
| Sex | Female |
| Sponsor | Pest County Flór Ferenc Hospital Academic / other |
| Locations | 3 sites (Budapest, Budapest and 2 other locations) |
| Trial ID | NCT07170514 on ClinicalTrials.gov |
What this trial studies
In this randomized trial 200 adults undergoing elective laparoscopic gynecological surgery with otherwise non-injured lungs will be assigned to PEEP titration guided by either EIT or dynamic pulmonary compliance. The EIT group will receive decremental PEEP titration using a PulmoVista 500 device to identify an individual optimal PEEP, while the compliance group will use dynamic compliance–directed titration. Key outcomes include mechanical power of ventilation, oxygenation, respiratory mechanics, global inhomogeneity index, overdistension/collapse metrics and postoperative pulmonary complications. The study aims to determine whether EIT guidance can reduce ventilator mechanical power and related postoperative lung problems compared with the established compliance-guided approach.
Who should consider this trial
Good fit: Adults (over 18) scheduled for elective laparoscopic gynecological surgery with consent and without severe chronic lung disease or other listed exclusions are ideal candidates.
Not a fit: People with severe COPD or restrictive lung disease, uncontrolled asthma, pulmonary metastases, prior thoracic surgery, extreme obesity (BMI >35), ASA IV status, or those unable/unwilling to consent are unlikely to benefit from participation.
Why it matters
Potential benefit: If successful, EIT-guided PEEP could lower mechanical power and improve oxygenation during surgery, which may reduce postoperative pulmonary complications and shorten hospital recovery.
How similar studies have performed: Dynamic compliance–guided ventilation has documented advantages, and smaller physiologic studies suggest EIT can better individualize PEEP, but large randomized evidence showing clear clinical outcome benefits for EIT is still limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion criteria: * Patient scheduled for elective laparoscopic gynaecological surgery * Age \> 18 years * Signed consent to participate in the trial Exclusion criteria: * Age \< 18 years * American Society of Anesthesiologists (ASA) physical status IV * History of severe restrictive or chronic obstructive pulmonary disease (COPD, Global Initiative for Chronic Obstructive Lung Disease grades III or IV) * Uncontrolled bronchial asthma * Pulmonary metastases * History of any thoracic surgery * Need for thoracic drainage before surgery * Congestive heart failure (NYHA grades III or IV) * Extreme obesity (BMI\>35 kg m-2) * Lack of patient's consent
Where this trial is running
Budapest, Budapest and 2 other locations
- Semmelweis University — Budapest, Budapest, Hungary (Not_yet_recruiting)
- Semmelweis Hospital Kiskunhalas — Kiskunhalas, Bács-Kiskun county, Hungary (Not_yet_recruiting)
- Flór Ferenc Hospital Kistarcsa — Kistarcsa, Pest County, Hungary (Recruiting)
Study contacts
- Study coordinator: Zoltán Ruszkai, MD, PhD
- Email: ruszkai.zoltan@florhosp.hu
- Phone: 36-20-915-1978
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.