Lung Protective Ventilation and Driving Pressure Guided PEEP Titration in CABG Surgery

Launched by KOCAELI UNIVERSITY · Jun 23, 2025

Keywords

ClinConnect Summary

This clinical trial is studying two different ways to help patients breathe during heart surgery where a heart-lung machine is used. Specifically, it compares a fixed setting versus a personalized setting of a breathing support called PEEP (Positive End-Expiratory Pressure), which helps keep the lungs open and protects them during surgery. The researchers want to see which method improves oxygen levels, heart function, lung flexibility, and breathing pressures during the operation. They will also look at recovery after surgery, including how quickly patients can have their breathing tubes removed, whether they develop lung problems, if they need extra breathing support, and how long they stay in the ICU and hospital.

People who might join this study are adults aged 18 to 70 who are scheduled for planned heart bypass surgery using a heart-lung machine. To join, patients need to be generally healthy enough for surgery (classified as ASA II-III) and not have certain conditions like very weak heart function, recent lung problems, severe obesity, or other serious health issues listed by the researchers. If eligible, participants will receive one of the two breathing support methods during their surgery, and the medical team will carefully monitor their breathing, oxygen levels, and recovery afterward. This study is not yet recruiting patients but aims to find the best way to protect lungs and improve recovery during and after heart surgery.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients scheduled for elective on-pump coronary artery bypass graft surgery via median sternotomy
• • Patients between the ages of 18 and 70
• • ASA (American Society of Anesthesiologists) physical status classification II-III
• Exclusion Criteria:
• • Patients with an ejection fraction below 35%
• • Patients who did not consent to participate in the study
• • Patients undergoing emergency surgery
• • Patients who are allergic to the anesthetic drugs used
• • Patients who have undergone lung resection
• • Those with a history of mechanical ventilation in the 2 months before surgery
• • Patients who have undergone total circulatory arrest and deep hypothermia
• • Patients with obstructive sleep apnea syndrome requiring long-term ventilation assistance
• • Morbid obesity (Body Mass Index\>35kg/m2)
• • Patients with refractory hypoxemia (arterial oxygen saturation below 88% despite 100% oxygen inhalation)
• • COPD (FEV1\<70%)
• • Patients with chronic renal failure (serum creatine\>1.8 mg/dl)
• • Anemia (Hg\<10 gr/dl)
• • Patients who have had an intraaortic balloon pump placed.