Stepwise PEEP versus sustained inflation for lung recruitment after bariatric surgery

Comparison of Stepwise PEEP vs Sustained Inflation Recruitment Maneuvers on Postoperative Oxygenation and Atelectasis in Bariatric Surgery Patients

This tests two ways to reopen the lungs at the end of laparoscopic bariatric surgery—stepwise increases in PEEP or a single sustained inflation—for adults with BMI 35–60.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 100 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Ain Shams University (other)
• Locations: 1 site (Cairo)
• Trial ID: NCT07525232 on ClinicalTrials.gov

What this trial studies

Adults undergoing laparoscopic bariatric procedures are randomized to receive either a sustained manual inflation (a 30-second manual inflation to a peak airway pressure of 30 cmH2O) or a stepwise PEEP recruitment maneuver (incremental increases of PEEP until peak airway pressure reaches 30 cmH2O, held and then decreased). Respiratory settings and the timing of the maneuvers are standardized and performed at the end of surgery before emergence from anesthesia. Patients with severe pre-existing pulmonary disease, baseline hypoxemia, prior pneumothorax, bullae, or history of barotrauma are excluded. The trial compares safety and short-term respiratory outcomes between the two techniques.

Who should consider this trial

Good fit: Adults (≥18 years) with BMI 35–60 undergoing laparoscopic sleeve gastrectomy or mini gastric bypass who are ASA physical status II and have no severe pre-existing lung disease.

Not a fit: Patients with severe pulmonary disease, baseline SpO2 <92% on room air, previous pneumothorax, known pulmonary bullae or a history of barotrauma are excluded and would not be eligible or likely to benefit.

Why it matters

Potential benefit: If successful, one method could improve oxygenation and reduce postoperative lung complications after bariatric surgery while minimizing hemodynamic or barotrauma risks.

How similar studies have performed: Similar recruitment maneuvers have been tested in obese and surgical populations with mixed results—improvements in oxygenation are common but gains in clinical outcomes and safety vary between techniques.

Eligibility criteria

Inclusion Criteria:

1. Anesthesiologists (ASA) physical status II, of either sex Age ≥18 y.
2. Undergoing laparoscopic bariatric surgeries; sleeve gastrectomy, mini gastric bypass
3. BMI (35-60)

Exclusion Criteria:

1. Pre-existing severe pulmonary disease
2. Baseline hypoxemia SpO₂ \<92% on room air
3. History of barotrauma
4. Previous pneumothorax
5. Known pulmonary bullae or emphysematous blebs

Where this trial is running

Cairo

• Ain Shams university hospitals — Cairo, Egypt (RECRUITING)

Study contacts

• Study coordinator: amr fouad, M.D

Conditions: Recruitment, Bariatric Surgery Candidate