Mechanical Power in One-lung Ventilation (POWEROL)

Postoperative Complications and Outcomes Related to Mechanical Power in One-lung Ventilation- A Multicentre Observational Study

Thoracic surgery usually necessitates one-lung ventilation (OLV) to provide surgical access while maintaining adequate gas exchange. However, OLV is associated with an increased risk of PPCs , a major cause of morbidity and mortality. Mechanical power, a composite parameter incorporating tidal volume, respiratory rate, driving pressure, and flow resistance, has been proposed as a key factor influencing ventilator-induced lung injury (VILI) and postoperative outcome. Understanding the association between mechanical power during OLV and PPCs could provide insights for optimizing intraoperative ventilatory strategies and reducing the burden of PPCs. As OLV inherently alters normal lung mechanics by decreasing functional residual capacity and introducing inequalities in ventilation-perfusion ratio, the complexity of managing mechanical power becomes even more pronounced. Under these altered conditions, the risk of PPC-including atelectasis, pneumonia, and respiratory failure-can be significantly elevated. Factors such as ventilatory settings, lung protection strategies, and the duration of OLV play pivotal roles in influencing mechanical power delivery and thereby impacting lung function recovery post-surgery. Current literature indicates a correlation between inappropriate mechanical ventilation strategies during OLV and increased incidence of PPCs. However, there remains a gap in understanding how precisely mechanical power, as a quantifiable measure, influences patient outcomes following OLV. Therefore, this study aims to investigate the relationship between mechanical power during OLV and the subsequent risk of PPC. By elucidating these dynamics, the findings may inform clinical practices surrounding OLV management, ultimately improving patient safety and outcomes in thoracic surgery.

Study Overview

• Status: Not yet recruiting
• Conditions: Thoracic Anesthesia; Thoracotomy Surgery

• Study Type: Observational
• Enrollment (Estimated): 300

Contacts and Locations

• Study Contact: Name: CIGDEM YILDIRIM GUCLU, Prof Dr; Phone Number: +905324576648; Email: drcigdemyldrm@yahoo.com.tr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

hospital

Description

Inclusion Criteria:

1. Patients aged 18 years or older,
2. ASA physical status I-IV
3. All thoracic surgeries
4. One lung ventilation period >1 hour
5. Patients capable of giving written informed consent

Exclusion Criteria:

1-Patients undergoing cardiac surgery

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of PPCs during the first five postoperative days, defined according to standard criteria	Postoperative pulmonary complications ;(e.g., pneumonia, acute respiratory distress syndrome [ARDS], or prolonged mechanical ventilation).According to StEP-COMPAC group definition [Abbott et al. 2018 Br J Anaesth 2018 May;120(5):1066-1079.]	From enrollment to the end of postoperative 5 th day

Secondary Outcome Measures

Outcome Measure	Time Frame
Threshold mechanical power (J/min)associated with PPCs	From enrollment to postoperative 5 th day
Unscheduled ICU admission rates	From enrollment to postoperative 5 th day
Extra-pulmonary postoperative complications(number of complications)	From enrollment to postoperative 5 th day
Length of ICU stay(day)	up to 5 th day
Length of hospital stay(day)	From enrollment to postoperative 5 th day

Collaborators and Investigators

• Sponsor: Ankara University

Study record dates

Study Major Dates

• Study Start (Estimated): February 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: December 9, 2025
• First Submitted That Met QC Criteria: January 19, 2026
• First Posted (Actual): January 20, 2026

Study Record Updates

• Last Update Posted (Actual): January 20, 2026
• Last Update Submitted That Met QC Criteria: January 19, 2026
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Keywords: one lung ventilation; mechanical power; postoperative pulmonary complications
• Other Study ID Numbers: 15.10.2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No