Research

Proposal Overview

Trial: Individualized Intraoperative Protective Ventilation using an Open Lung Approach with Driving Pressure Limitation

PI: Dr. Randal Blank, MD, PhD

Institution: University of Virginia School of Medicine

Postoperative pulmonary complications (PPCs) are common after general surgery, and dramatically increase health costs, hospital length of stay, and risk of mortality. Lung protective ventilation (LPV) approaches have demonstrated significant potential to mitigate the injurious effects of mechanical ventilation and improve clinical outcomes after major surgery. However, the historical and ongoing focus on ventilator parameters that are easily controlled but have no direct demonstrated mechanistic relationship to pulmonary morbidity (e.g. tidal value and positive end-expiratory pressure) has contributed to difficulties in defining an optimal LPV strategy. We propose to test whether a LPV regimen that combines an open lung strategy with a strategy designed to limit airway driving pressure reduces the incidence of postoperative complications in an intermediate to high risk surgical patient population, compared to standard LPV management. Participating centers will be chosen on the basis of (1) participation in MPOG; (2) availability of site resources to appoint study personnel; and (3) ability to record ventilator plateau pressure data. Patients will be randomized with the use of web-based central randomization program within an MPOG platform specifically designed for pragmatic clinical trials. We will support this study with a grant from the NIH.

Contact Information

Randal Blank, MD, PhD

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