Clinical Research Directory

Cerebral Hemodynamic Effects of Individualized PEEP During Robotic Prostatectomy

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.

Effects of Bicarbonate Spring Water Immersion on Cognitive Reliability and Post-Maximal Exercise Recovery in Adolescent Rowers During Altitude Training: A Sex-Stratified Three-Arm Randomized Controlled Trial

This randomized controlled trial aims to investigate the effects of hot spring bath therapy on cognitive function recovery, cerebral hemodynamics, and athletic performance in athletes undergoing altitude training. Participants will be randomly assigned to either a hot spring intervention group, a hot water control group, or a blank control group. The hot spring intervention group receives hot spring baths (38°C, 20 minutes) combined with altitude training; the hot water control group receives hot water baths (38°C, 20 minutes) combined with altitude training; and the blank control group receives standard recovery procedures combined with altitude training. Primary outcome measures include cognitive performance assessments (Stroop test, psychomotor vigilance test) and cerebral hemodynamic indicators (functional near-infrared spectroscopy, transcranial Doppler ultrasound). Secondary outcomes included exercise capacity (maximal oxygen uptake, triathlon performance, 500-meter test), blood lactate, and hematological parameters (white blood cells, neutrophils, platelets). These findings may provide evidence for non-pharmacological interventions to enhance cognitive recovery and brain adaptation during altitude training.