Mechanical Power in One-lung Ventilation

NCT07353788 | Not Yet Recruiting DMC

• 1 other identifier: 15.10.2025
• Study Type: observational
• Target: 300
• Locations: 0 countries
• Sites: N/A

Brief Summary

Thoracic surgery usually necessitates one-lung ventilation (OLV) to provide surgical access while maintaining adequate gas exchange. However, OLV is associated with an increased risk of PPCs , a major cause of morbidity and mortality. Mechanical power, a composite parameter incorporating tidal volume, respiratory rate, driving pressure, and flow resistance, has been proposed as a key factor influencing ventilator-induced lung injury (VILI) and postoperative outcome. Understanding the association between mechanical power during OLV and PPCs could provide insights for optimizing intraoperative ventilatory strategies and reducing the burden of PPCs. As OLV inherently alters normal lung mechanics by decreasing functional residual capacity and introducing inequalities in ventilation-perfusion ratio, the complexity of managing mechanical power becomes even more pronounced. Under these altered conditions, the risk of PPC-including atelectasis, pneumonia, and respiratory failure-can be significantly elevated. Factors such as ventilatory settings, lung protection strategies, and the duration of OLV play pivotal roles in influencing mechanical power delivery and thereby impacting lung function recovery post-surgery. Current literature indicates a correlation between inappropriate mechanical ventilation strategies during OLV and increased incidence of PPCs. However, there remains a gap in understanding how precisely mechanical power, as a quantifiable measure, influences patient outcomes following OLV. Therefore, this study aims to investigate the relationship between mechanical power during OLV and the subsequent risk of PPC. By elucidating these dynamics, the findings may inform clinical practices surrounding OLV management, ultimately improving patient safety and outcomes in thoracic surgery.

Conditions

Thoracotomy Surgery; Thoracic Anesthesia

Keywords

one lung ventilation; mechanical power; postoperative pulmonary complications

Outcome Measures

Primary Outcomes (1)

• Number of PPCs during the first five postoperative days, defined according to standard criteria

  Postoperative pulmonary complications ;(e.g., pneumonia, acute respiratory distress syndrome \[ARDS\], or prolonged mechanical ventilation).According to StEP-COMPAC group definition \[Abbott et al. 2018 Br J Anaesth 2018 May;120(5):1066-1079.\]

  From enrollment to the end of postoperative 5 th day

Secondary Outcomes (5)

• Threshold mechanical power (J/min)associated with PPCs

  From enrollment to postoperative 5 th day

• Unscheduled ICU admission rates

  From enrollment to postoperative 5 th day

• Extra-pulmonary postoperative complications(number of complications)

  From enrollment to postoperative 5 th day

• Length of ICU stay(day)

  up to 5 th day

• Length of hospital stay(day)

  From enrollment to postoperative 5 th day

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

hospital

You may qualify if:

• Patients aged 18 years or older,
• ASA physical status I-IV
• All thoracic surgeries
• One lung ventilation period \>1 hour
• Patients capable of giving written informed consent

You may not qualify if:

• Patients undergoing cardiac surgery

Sponsors & Collaborators

• Ankara University: lead

Central Study Contacts

CIGDEM YILDIRIM GUCLU, Prof Dr

CONTACT

+905324576648; drcigdemyldrm@yahoo.com.tr

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical professor

Study Record Dates

• First Submitted: December 9, 2025
• First Posted: January 20, 2026
• Study Start: February 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: January 20, 2026

Record last verified: 2025-10