Lung Ultrasound Assessment of Postoperative Atelectasis After Mechanical Ventilation With Minimum Driving Pressure

Brief summary The goal of this clinical trial is to compare two different types of perioperative mechanical ventilation (MV), specifically Protective Mechanical Ventilation (PMV) and MV with the lowest possible Driving Pressure (ΔP), in relation to the appearance of postoperative lung closing, eg atelectasis, in adult patients who are operated. Atelectasis will be evaluated via lung ultrasound. The main questions it aims to answer are: * Is MV with lower ΔP better than conventional PMV in keeping lungs more open perioperatively and immediately postoperatively? * Does MV with lower ΔP decrease hospital stay, Intensive Care Unit (ICU) need and mortality? Researchers will use lung ultrasound to compare MV with the lowest possible Driving Pressure (ΔP) to Protective Mechanical Ventilation (PMV) to see if any of this is more protective than the other concerning lung atelectasis. All participants will receive perioperative MV. Half of them will receive conventional Protective Mechanical Ventilation (PMV). This will include well known generally protective settings for mechanical ventilation of patients, concerning volumes, pressures, respiratory rate, inspiratory gases and ventilation maneuvers. The rest of participants will be ventilated with the lowest possible Driving Pressure (ΔP). This will be similar to PMV in the chosen volumes, respiratory rate, inspiratory gases and ventilation maneuvers. However, the pressure inside lung at the end of expiration, eg Positive End Expiratory Pressure (PEEP), will be not be preset for every patient. Initially, we will perform a maneuver that will quantify each individual's lung characteristics and mechanics. According to this, we will find the exact PEEP that seems to suit each patients lungs most, and use this perioperatively, trying to provide lungs the best conditions every time. After the completion of the operation, all the patients will be screened for atelectasis, via lung ultrasound, using a well established protocol for the quantification of atelectasis. The results will be statistically analyzed trying to find if any of the forementioned strategies of mechanical ventilation surpasses the other concerning atelectasis appearance. Furthermore efficiency of lung oxygen absorption, hospital stay, ICU need and mortality will be noted.

NCT Number	NCT07186920
Lead Sponsor	University General Hospital of Patras
Conditions	Postoperative Atelectasis, Postoperative Pulmonary Atelectasis, Postoperative Pulmonary Complications (PPCs), Lung Ultrasonography Score, Lung Ultrasound
Enrollment	70 participants
Start Date	2025-10-06
Primary Completion	2025-12-31 (estimated)
Study Completion	2026-01-15 (estimated)
Updated on ClinicalTrials.gov	2026-02-11