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Evaluation of the Effectiveness of Lung-Protective Ventilation in Patients Undergoing Laparoscopic Gastrectomy
Sponsor: University Medical Center Ho Chi Minh City (UMC)
Summary
The goal of this clinical trial is to learn if lung-protective ventilation can improve perioperative oxygenation and reduce postoperative pulmonary complications in patients undergoing elective laparoscopic gastrectomy. The main questions it aims to answer are: * Does lung-protective ventilation improve intraoperative and postoperative gas exchange compared to conventional ventilation? * What are the effects of this ventilation strategy on pulmonary mechanics, hemodynamic parameters, and the incidence of postoperative pulmonary complications? Researchers will compare lung-protective ventilation to conventional ventilation to see if the protective strategy safely mitigates atelectasis and improves oxygenation during surgery. Participants will: * Receive either conventional ventilation or lung-protective ventilation (using lower tidal volumes with appropriate PEEP and recruitment maneuvers) while under general anesthesia for their surgery. * Have their gas exchange, pulmonary mechanics, and hemodynamic parameters continuously monitored during and after the operation. * Be assessed for any postoperative pulmonary complications following the surgery.
Key Details
Gender
All
Age Range
18 Years - 70 Years
Study Type
INTERVENTIONAL
Enrollment
102
Start Date
2025-12-01
Completion Date
2026-12-31
Last Updated
2026-09-16
Healthy Volunteers
No
Interventions
Conventional Ventilation
Patients in this group will receive conventional intraoperative mechanical ventilation during surgery. The ventilator settings include a tidal volume (VT) of 8 ml/kg based on predicted body weight (PBW) and a positive end-expiratory pressure (PEEP) of 5 cmH2O.
Lung-Protective Ventilation
Patients assigned to the lung-protective ventilation arm will receive a standardized intraoperative strategy using Volume-Controlled Ventilation (VCV) with a tidal volume of 6 ml/kg based on predicted body weight, a respiratory rate of 12 breaths per minute, an I:E ratio of 1:2, and an inspiratory pause greater than 0.2 seconds to minimize resistance for compliance calculations. Following an initial alveolar recruitment maneuver, a decremental PEEP titration will be performed by starting at 14 cmH2O and decreasing by 2 cmH2O every 4 minutes down to a minimum of 6 cmH2O to identify and maintain the optimal PEEP level, which is defined as the point of highest dynamic lung compliance. Furthermore, automated alveolar recruitment maneuvers applying a sustained pressure of 40 cmH2O for 15 seconds will be systematically executed immediately after endotracheal intubation, repeated every 30 minutes throughout the surgical procedure, and performed a final time immediately before extubation.
Locations (1)
University Medical Center HCMC
Ho Chi Minh City, Ho Chi Minh, Vietnam