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Cerebral Hemodynamic Effects of Individualized PEEP During Robotic Prostatectomy
Sponsor: Istanbul University
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
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.
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)