Bedside Lung Ultrasound to Monitor Lung Recruitment in Obese Patients

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Conditions studied: Morbid Obesity, Obesity, Respiratory Failure, Atelectasis, Ventilator-Induced Lung Injury (VILI)

In brief

Patients with morbid obesity who require a breathing machine (mechanical ventilator) in the Intensive Care Unit (ICU) frequently experience partial lung collapse. This happens because the extra weight of the chest and abdomen presses on the lungs, reducing their capacity and making it difficult to maintain adequate oxygen levels. To address this, doctors often perform a standard lung recruitment maneuver, which involves temporarily increasing the air pressure from the ventilator to gently pop open the collapsed lung areas. However, standard bedside monitoring tools make it difficult to see exactly how well the different regions of the lungs are reopening. This prospective observational study aims to evaluate the use of Bedside Lung Ultrasound (LUS), which is a safe, radiation-free imaging tool, to monitor how well the lungs respond to these maneuvers in real-time. During the study, researchers will use a standardized 12-zone ultrasound scan to examine the lungs of mechanically ventilated adult patients (BMI ≥ 33 kg/m²) before, during, and after a step-by-step lung recruitment maneuver. By calculating a "Total Lung Ultrasound Score," the medical team can directly visualize and measure the transition from collapsed tissue to normal, aerated lung tissue. Furthermore, the ultrasound will be used during a step-down pressure phase to help identify the patient's "optimal PEEP" (Positive End-Expiratory Pressure), which is the exact customized pressure needed to keep the lungs open after the maneuver is complete, thereby improving oxygenation and minimizing the risk of lung injury.

Key facts

Study ID: NCT07542093
Run by: Assiut University
People needed: 45
Starts: 2026-05-01
Expected to finish: 2027-06-01
Last updated by the study team: 2026-04-21

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Adult patients aged >18 years
BMI ≥ 33 kg/m² (morbid obesity)
Intubated and receiving invasive mechanical ventilation for any indication (elective surgery, respiratory failure, post-operative ICU admission)
Expected duration of mechanical ventilation ≥ 6 hours
Hemodynamically stable at enrollment: Mean Arterial Pressure (MAP) ≥ 65 mmHg without escalating vasopressor support
SpO₂ ≥ 85% on current ventilator settings
Written informed consent obtained from patient or legal guardian

You may not qualify if…

Known or suspected pneumothorax or bullous emphysema (contraindication to recruitment maneuvers)
Severe hemodynamic instability: MAP < 60 mmHg or requiring high-dose vasopressors (norepinephrine > 0.3 mcg/kg/min)
Active bronchopleural fistula
Recent thoracic or cardiac surgery (within 48 hours) where high airway pressures are contraindicated
Raised intracranial pressure (ICP) or known severe traumatic brain injury
Confirmed ARDS with PaO₂/FiO₂ ratio < 100 mmHg (severe ARDS, where recruitment strategy differs significantly)
Chest wall deformity or subcutaneous emphysema that precludes reliable lung ultrasound assessment
Refusal of consent

Full record on ClinicalTrials.gov

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