Protective Ventilation With High Versus Low PEEP During One-lung Ventilation for Thoracic Surgery

Summary

One-lung ventilation (OLV) with resting of the contralateral lung may be required to allow or facilitate thoracic surgery. However, OLV can result in severe hypoxemia, requiring a mechanical ventilation approach that is able to maintain adequate gas exchange, while protecting the lungs against postoperative pulmonary complications (PPCs). During OLV, the use of lower tidal volumes is helpful to avoid over-distension, but can result in increased atelectasis and repetitive collapse-and-reopening of lung units, particularly at low levels of positive end-expiratory pressure (PEEP).

Anesthesiologists inconsistently use PEEP and recruitment maneuvers (RM) in the hope that this may improve oxygenation and protect against PPC. Up to now, it is not known whether high levels of PEEP combined with RM are superior to lower PEEP without RM for protection against PPCs during OLV.

Hypothesis: An intra-operative ventilation strategy using higher levels of PEEP and recruitment maneuvers, as compared to ventilation with lower levels of PEEP without recruitment maneuvers, prevents postoperative pulmonary complications in patients undergoing thoracic surgery under standardized one-lung ventilation.

Conditions

• One-Lung Ventilation

Interventions

PROCEDURE

PEEP level

PROCEDURE

Use of recruitment maneuvers

Sponsors & Collaborators

• Istanbul University

  collaborator OTHER

• European Society of Anaesthesiology and Intensive Care

  collaborator OTHER

• Technische Universität Dresden

  lead OTHER

Principal Investigators

• Mert Sentürk · Istanbul University Hospital

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2017-01-31

Primary Completion

2024-08-31

Completion

2024-08-31

Countries

• United States
• Albania
• Austria
• Brazil
• Chile
• China
• Croatia
• Cyprus
• Czechia
• Egypt
• France
• Germany
• Greece
• Hungary
• Iraq
• Italy
• Japan
• Latvia
• Mexico
• Netherlands
• Romania
• Saudi Arabia
• Serbia
• Slovenia
• Spain
• Switzerland
• Taiwan
• Turkey (Türkiye)
• United Kingdom

Study Locations