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NOT YET RECRUITING
NCT07784010
NA

Cerebral Hemodynamic Effects of Individualized PEEP During Robotic Prostatectomy

Sponsor: Istanbul University

View on ClinicalTrials.gov

Summary

This randomized clinical trial will compare two approaches to setting positive end-expiratory pressure (PEEP) during robot-assisted radical prostatectomy performed in the Trendelenburg position. The study aims to determine whether individualized PEEP, selected according to the lowest driving pressure, affects cerebral blood flow and brain oxygenation differently from standard PEEP. Approximately 45 adult patients undergoing robot-assisted radical prostatectomy will be randomly assigned to receive either individualized PEEP or standard PEEP during general anesthesia. Cerebral blood flow will be assessed noninvasively using transcranial Doppler ultrasound, and brain oxygenation will be monitored using near-infrared spectroscopy. Participants will also undergo brief assessments of attention, cognitive function, delirium, and sedation before and after surgery, with follow-up continuing for up to 48 hours after the operation. Both ventilation approaches are routinely used in clinical practice, and no experimental drug, device, or additional invasive procedure will be used as part of the study.

Official title: Comparison of the Effects of Individualized PEEP Titration Versus Standard PEEP on Transcranial Doppler-Measured Cerebral Hemodynamic Parameters and Postoperative Neurocognitive Functions in Patients Undergoing Robotic Prostatectomy in the Trendelenburg Position

Key Details

Gender

MALE

Age Range

18 Years - 80 Years

Study Type

INTERVENTIONAL

Enrollment

45

Start Date

2026-08-19

Completion Date

2026-11-30

Last Updated

2026-08-25

Healthy Volunteers

No

Interventions

OTHER

Individualized PEEP Titration

Following a recruitment maneuver, PEEP will be decreased from 15 to 5 cmH2O in 1-cmH2O steps. Respiratory mechanics will be assessed after 12 respiratory cycles at each step, and the PEEP level producing the lowest driving pressure will be selected as the individualized PEEP and maintained.

OTHER

Standard PEEP Group

Following a recruitment maneuver, PEEP will be maintained at a fixed level of 6 cmH2O during mechanical ventilation.

Locations (1)

Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine

Istanbul, Turkey (Türkiye)