EIT vs Dynamic Compliance Guided PEEP Titration During Laparoscopic Gynecological Surgery

The goal of this randomized controlled clinical trial is to compare the pulmonary protective effects of two different positive end-expiratory pressure (PEEP) titrating methods in patients with non-injured lungs undergoing laparoscopic gynecological surgery. Despite dynamic pulmonary compliance (Cdyn) guided lung protective ventilation has several proven advantages, the investigators hypothesize that optimizing intraoperative mechanical ventilation using electrical impedance tomography (EIT) may further improve patient outcomes, enhance postoperative recovery, shorten in-hospital stay and reduce healthcare related costs. The main questions aim to answer are: * May EIT-guided PEEP titration reduce the mechanical power of ventilation and improve oxygenation more significantly than the Cdyn-guided method? * What effect might a decrease in mechanical power of ventilation have on postoperative pulmonary complications? Participants will: * Receive an EIT-guided or a Cdyn-guided PEEP titration procedure during laparoscopic gynecological surgery. * Be assessed for mechanical power of ventilation, oxygenation, atelectasis and postoperative pulmonary complications during and 2 days after surgery. * Be followed-up for mortality until the 28th postoperative day.

NCT Number	NCT07170514
Lead Sponsor	Pest County Flór Ferenc Hospital Collaborators: Kiskunhalas Semmelweis Hospital the Teaching Hospital of the University of Szeged, Semmelweis University
Conditions	Mechanical Power, Postoperative Pulmonary Complications (PPCs), Oxygenation
Enrollment	200 participants
Start Date	2025-11-10
Primary Completion	2027-09-30 (estimated)
Study Completion	2027-10-30 (estimated)
Updated on ClinicalTrials.gov	2026-04-14