Driving Pressure During General Anesthesia for Open Abdominal Surgery (DESIGNATION): study protocol of a randomized clinical trial

Liselotte Hol, Liselotte Hol, Sunny G. L. H. Nijbroek, Ary Serpa Neto, Marcelo Gama de Abreu, Paolo Pelosi, Sabrine N. T. Hemmes, Leon P. H. J. Aarts, Ronald D. L. Akkerman, Juliette J. E. Albersen, Caterina Aurilio, Denise Battaglini, Hans D. de Boer, Annemieke Boom, Christa Boer, Tammo Brouwer, Wolfgang F. F. A. Buhre, Carolina S. E. Bulte, Gitara M. Edward-Rutten, Marc B. GodfriedHendrik J. F. Helmerhorst, Jan Hofland, Hester Hoogenboom, W. Ten Hoope, Bernard M. Houweling, Ragnar Huhn, Wanda Konijn, Ankie W. M. M. Koopman-van Gemert, Dianne J. De Korte-de Boer, Minke C. Kortekaas, Felix Van Lier, Benedikt Preckel, Mandana Rad, Pasquale Sansone, Andre Stamkot, Robert Jan Stolker, Bram Thiel, Johannes F. H. Ubben, Michel M. R. F. Struys, Bastiaan A. In 't Veld, Hermann Wrigge, Miriam Zeillemaker-Hoekstra, Tim van der Zwan, Johannes H. M. J. Zwijsen, Markus W. Hollmann, Marcus J. Schultz, DESIGNATION–Investigators

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Abstract

Background Intraoperative driving pressure (Delta P) is associated with development of postoperative pulmonary complications (PPC). When tidal volume (V-T) is kept constant, Delta P may change according to positive end-expiratory pressure (PEEP)-induced changes in lung aeration. Delta P may decrease if PEEP leads to a recruitment of collapsed lung tissue but will increase if PEEP mainly causes pulmonary overdistension. This study tests the hypothesis that individualized high PEEP, when compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery. Methods The "Driving prESsure durIng GeNeral AnesThesIa for Open abdomiNal surgery trial" (DESIGNATION) is an international, multicenter, two-group, double-blind randomized clinical superiority trial. A total of 1468 patients will be randomly assigned to one of the two intraoperative ventilation strategies. Investigators screen patients aged >= 18 years and with a body mass index

Original languageEnglish
Article number198
Number of pages15
JournalTrials
Volume21
Issue number1
DOIs
Publication statusPublished - 18 Feb 2020

Keywords

  • Mechanical ventilation
  • Intraoperative ventilation
  • Delta P
  • Compliance
  • Positive end-expiratory pressure
  • Recruitment maneuver
  • Pulmonary complications
  • Postoperative complications
  • Postoperative pulmonary complications
  • END-EXPIRATORY-PRESSURE
  • POSTOPERATIVE PULMONARY COMPLICATIONS
  • PROTECTIVE MECHANICAL VENTILATION
  • CHEST-WALL MECHANICS
  • LOW-TIDAL-VOLUME
  • OBESE-PATIENTS
  • LUNG
  • ATELECTASIS
  • DEFINITIONS
  • PREVENTION

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