Optimal Level of PEEP in Protective One-lung Ventilation

Optimal Level of Positive End-expiratory Pressure to Reduce Postoperative Atelectasis After Lung Resection With Protective One-lung Ventilation

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT03856918

Enrollment

142

Registered

2019-02-27

Start date

2019-05-28

Completion date

2021-02-28

Last updated

2022-04-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Positive End-expiratory Pressure, Postoperative Atelectasis, Video-assisted Thoracic Surgery

Keywords

Protective ventilation, One-lung ventilation

Brief summary

Protective ventilation strategy has been widely applied in the field of thoracic surgery requiring one-lung ventilation to reduce postoperative pulmonary complications. Low tidal volume, positive end-expiratory pressure (PEEP), and intermittent recruitment maneuver are key components of protective ventilation strategy. Recent evidence suggests that a tidal volume of 4-5 ml/kg should be applied during protective one-lung ventilation. However, optimal level of PEEP is still unclear. This study aims to investigate optimal level of PEEP to minimize postoperative atelectasis by comparing modified lung ultrasound score in patients applied protective one-lung ventilation using PEEP of 3, 6, or 9 cm of water during thoracic surgery.

Interventions

PROCEDUREPEEP 3 cm of water

PEEP of 3 cm of water will be applied during one-lung ventilation.

PROCEDUREPEEP 6 cm of water

PEEP of 6 cm of water will be applied during one-lung ventilation.

PROCEDUREPEEP 9 cm of water

PEEP of 9 cm of water will be applied during one-lung ventilation.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

TRIPLE (Subject, Caregiver, Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

19 Years to 80 Years

Healthy volunteers

Inclusion criteria

* Patients undergoing Video-assisted Thoracic Surgery under one-lung ventilation

Exclusion criteria

* Moderate to severe obstructive/restrictive pattern in preoperative pulmonary function test * Chronic kidney disease * Coronary artery disease * Pulmonary hypertension * Bilateral lung surgery * Conversion to thoracotomy * American Society of Anesthesiologists physical status IV or more * Refusal to participate

Design outcomes

Primary

Measure	Time frame	Description
Modified lung ultrasound score	Postoperative 1 hour	The score is calculated by adding up the 12 individual quadrant scores assessed using lung ultrasound.

Secondary

Measure	Time frame	Description
Intraoperative partial pressure of arterial oxygen/fraction of inspired oxygen ratio	Average time of 60-90 minutes	partial pressure of arterial oxygen/fraction of inspired oxygen ratio during one-lung ventilation
Postoperative desaturation	Postoperative 24 hours	Oxygen saturation by pulse oximetry \<95%
plasma Tumor Necrosis Factor-α	10 minutes after initiation of one-lung ventilation	proinflammatory cytokine
Intraoperative desaturation	Average time of 60-90 minutes	Oxygen saturation by pulse oximetry \<95% during one-lung ventilation
plasma Interleukin-10	10 minutes after initiation of one-lung ventilation	anti-inflammatory cytokine
Postoperative pulmonary complication	Postoperative 7 days	Composite outcome of atelectasis, pneumonia, acute respiratory distress syndrome, or pulmonary aspiration
plasma Interleukin-6	10 minutes after initiation of one-lung ventilation	proinflammatory cytokine

Countries

South Korea

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026