NCT07531602|Enrolling By Invitation
Effect of PEEP on Cardiac Function
The Effect of Positive End-Expiratory Pressure on Biventricular Mechanics in the Perioperative Setting
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The Effect of Positive End-Expiratory Pressure on Biventricular Mechanics in the Perioperative Setting
Sponsor study identifier
interventional
28
1 country
1
Study Start
June 17, 2026
Actual (reported)Primary Completion
July 30, 2028
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
October 30, 2028
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
The purpose of this single-center, prospective study is to evaluate the physiologic effect of changes in PEEP on biventricular mechanics and RV-pulmonary arterial (RV-PA) coupling in adult patients undergoing cardiac surgery.
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
October 30, 2028
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
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Some registry-reported names shown below are not yet linked in this graph.
Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
April 9, 2026
Actual (reported)April 15, 2026
Actual (reported)June 17, 2026
Actual (reported)July 30, 2028
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
October 30, 2028
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Right ventricle-pulmonary artery coupling (Ees/Ea)
Right ventricle-pulmonary artery (RV-PA) coupling ratio (Ees/Ea) assessed using simultaneous transesophageal echocardiography and hemodynamic monitoring at four predefined PEEP levels (optimal PEEP + 5 cmH₂O, optimal PEEP, optimal PEEP - 5 cmH₂O, and PEEP 0 cmH₂O \[baseline\]) during a standardized stepwise PEEP titration sequence.
During the standardized PEEP titration sequence after induction of anesthesia and before surgical intervention (approximately 20-25 minutes)
Right ventricular end-diastolic volume at predefined PEEP levels
During PEEP titration sequence (approximately 20-25 minutes after induction of anesthesia and prior to surgical incision)
Right ventricular end-systolic volume at predefined PEEP levels
During standardized PEEP titration sequence after induction of anesthesia and prior to surgical incision (approximately 20-25 minutes)
Right ventricular stroke volume at predefined PEEP levels
During standardized PEEP titration sequence after induction of anesthesia and prior to surgical incision (approximately 20-25 minutes)
Right ventricular end-diastolic pressure at predefined PEEP levels
During standardized PEEP titration sequence after induction of anesthesia and prior to surgical incision (approximately 20-25 minutes)
Right ventricular end-systolic pressure at predefined PEEP levels
During standardized PEEP titration sequence after induction of anesthesia and prior to surgical incision (approximately 20-25 minutes)
Oxygen saturation at predefined PEEP levels
During standardized PEEP titration sequence after induction of anesthesia and prior to surgical incision (approximately 20-25 minutes)
Plateau pressure at predefined PEEP levels
During standardized PEEP titration sequence after induction of anesthesia and prior to surgical incision (approximately 20-25 minutes)
These are patients undergoing cardiac surgery who will undergo an incremental/decremental PEEP trial using Electrical Impedance Tomography (EIT).
Electrical impedance tomography (EIT) will be used to guide identification of "optimal PEEP" based on lung mechanics. After induction of anesthesia and initiation of controlled mechanical ventilation, EIT data will be collected during a brief standardized PEEP titration maneuver to assess lung recruitment and overdistension.
Registry-reported names are shown in full. Names without a link have not yet been matched to a Syfrah profile.
Beth Israel Deaconess Medical Center
Boston, Massachusetts, 02115, United States
Bellofiore A, Vanderpool R, Brewis MJ, Peacock AJ, Chesler NC. A novel single-beat approach to assess right ventricular systolic function. J Appl Physiol (1985). 2018 Feb 1;124(2):283-290. doi: 10.1152/japplphysiol.00258.2017. Epub 2017 Oct 12.
Araos J, Glocker F, Owyang CG, Teran F, Kim J, Nieman G, Heerdt PM. Biventricular Response to Positive End-expiratory Pressure in Swine: Assessment Based on Beat-to-beat Pressure Waveform Analysis. Anesthesiology. 2025 Apr 1;142(4):767-769. doi: 10.1097/ALN.0000000000005363. Epub 2025 Feb 13. No abstract available.
First Submitted
April 9, 2026
First Posted
April 15, 2026
Study Start
June 17, 2026
Actual (reported)Primary Completion
July 30, 2028
EstimatedContact the study team to confirm eligibility.
Wood G, Madsen TL, Kim WY, Lyhne MD. Increasing Levels of Positive End-expiratory Pressure Cause Stepwise Biventricular Stroke Work Reduction in a Porcine Model. Anesthesiology. 2024 Feb 1;140(2):240-250. doi: 10.1097/ALN.0000000000004821.
Acosta P, Santisbon E, Varon J. "The use of positive end-expiratory pressure in mechanical ventilation". Crit Care Clin. 2007 Apr;23(2):251-61, x. doi: 10.1016/j.ccc.2006.12.012.
Ahmed U, Mahmood F, Nicoara A, Kiarad V. Right Ventricular Function and Echocardiographic Pressure-Volume Loops: Overview and Perioperative Clinical Implications. J Cardiothorac Vasc Anesth. 2025 Oct;39(10):2857-2865. doi: 10.1053/j.jvca.2025.05.019. Epub 2025 May 17.
Kiarad V, Mahmood F, Hedayat M, Yunus R, Nicoara A, Liu D, Chu L, Senthilnathan V, Kai M, Khabbaz K. Intraoperative right ventricular end-systolic pressure-volume loop analysis in patients undergoing cardiac surgery: A proof-of-concept methodology. JTCVS Open. 2024 Sep 26;22:225-234. doi: 10.1016/j.xjon.2024.09.020. eCollection 2024 Dec.
Planned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
October 30, 2028
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Last Updated
July 1, 2026
Record last verified: 2026-06
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Source: ClinicalTrials.gov.
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