Mechanical Power for Ventilatory Settings in Operating Room

Starting soon · Not applicable

Conditions studied: Postoperative Respiratory Failure, Abdominal Surgery, Postoperative Pulmonary Complications, Morality

In brief

Postoperative respiratory failure (PRF) is a dreaded complication that imposes a significant burden through unplanned admission to the ICU, post discharge disability and mortality. Despite widespread implementation of intraoperative lung-protective ventilation strategies over the past decade, results remain inconsistent. Interventions targeting individual parameters like tidal volume or positive end-expiratory pressure (PEEP) have shown equivocal results. The use of high PEEP and recruitment maneuvers raises safety concerns by possible negative hemodynamic effects. Recent studies suggest that individualizing ventilation strategies based on mechanical power-a composite parameter integrating tidal volume, plateau pressure, PEEP, and ventilator frequency-may better predict and help prevent PRF, independently of patients' baseline respiratory system compliance. These studies identified this parameter as interventional targets to reduce lung injury during mechanical ventilation. However, no multicenter randomized controlled trial has been performed in the field of ventilatory settings titration during invasive mechanical ventilation in operating room. The investigators hypothesize that a ventilation strategy aimed at decreasing mechanical power will reduce the incidence of PRF and mortality in patients undergoing abdominal surgery, compared with a standard strategy using fixed tidal volume and PEEP

Key facts

Study ID

NCT07620132

Run by

University Hospital, Montpellier

People needed

490

Starts

2026-06-01

Expected to finish

2029-01-01

Last updated by the study team

2026-06-02

Who can join

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

You may qualify if…

• Adult (≥ 18 years)
• Laparoscopic or non-laparoscopic abdominal surgery
• With an expected duration of at least 2 hours

You may not qualify if…

• Patients already receiving mechanical ventilation > 12 hours before surgery;
• Chronic respiratory disease requiring oxygen therapy or mechanical ventilation at home;
• Undrained pneumothorax or subcutaneous emphysema;
• Intracranial hypertension;
• Patients for which death is deemed imminent and inevitable or patients with an underlying disease process with a life expectancy of less than 3 months;
• Patients already enrolled in the IMPROVE III trial;
• Pregnancy in progress or planned during the study period or breastfeeding women (Art. L1121-5 of the French Public Health Code);
• Patients protected by law (Art. L1121-6 to L1121-8 of the French Public Health Code): Individuals deprived of their liberty by judicial or administrative decision, vulnerable persons, minors, adults under guardianship or curatorship;
• Patients not covered by a French social security scheme and not benefiting from such a scheme;
• Absence of free and informed oral consent from the patient before inclusion (except in emergency situation where the patient is unable to provide consent), or absence of written informed consent from his/her proxy if present in an emergency situation (except in life-threatening emergency, where inclusion without consent from the patient or his/her proxy is permitted), in which case consent will be obtained as soon as possible after inclusion.

Full record on ClinicalTrials.gov

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