The University of Texas Medical Branch, Galveston
The purpose of this study is to evaluate whether an intraoperative positive end-expiratory pressures (PEEP) setting strategy aimed at minimizing the mechanical power delivered to the lungs via transpulmonary pressure improves postoperative outcomes in obese patients undergoing conventional laparoscopic or robotic-assisted surgery. The objectives are to determine whether this strategy reduces immediate postoperative hypoxemia, and to assess whether it mitigates lung injury as reflected by relevant blood biomarkers.
Inclusion Criteria: 1. Age ≥ 18 years; 2. Body Mass Index (BMI) ≥ 35 kg/m2; 3. Scheduled for laparoscopic surgery expected to exceed 2h (from incision to closure) under general anesthesia, as determined pre-operatively by the attending surgeon and surgical team based on typical scheduling estimates, prior experience, procedure type, planned surgical approach, and patient-specific factors. Exclusion Criteria: 1. Previous lung surgery; 2. Invasive mechanical ventilation for \>30 minutes within the last 30 days prior to surgery; 3. Receipt of immunosuppressive medication (chemotherapy or radio…
Participants will receive standard intraoperative mechanical ventilation with a fixed positive end-expiratory pressure (PEEP) of 8 cmH₂O maintained throughout the surgical procedure.
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