Peak Airway Pressure and Respiratory Mechanics During PRVC Ventilation in Laparoscopic Surgery

Peak Airway Pressure and Respiratory Mechanics During Pressure-Regulated Volume Control Ventilation in Patients Undergoing Laparoscopic Abdominal Surgery: A Prospective Observational Study

This study aims to evaluate peak airway pressure and respiratory mechanics during pressure-regulated volume control (PRVC) ventilation in patients undergoing elective laparoscopic abdominal surgery. Pneumoperitoneum and patient positioning during laparoscopic procedures can significantly affect respiratory mechanics, including airway pressures and lung compliance.

The study will assess changes in peak airway pressure, dynamic compliance, and other ventilatory parameters during different intraoperative phases. The findings are expected to provide insights into optimizing ventilatory strategies to improve patient safety and minimize ventilator-associated complications during laparoscopic surgery.

Study Overview

• Status: Not yet recruiting
• Conditions: Respiratory Mechanics; Intraoperative Ventilation
• Intervention / Treatment: Other: PRVC Ventilation

Detailed Description

Laparoscopic abdominal surgery requires the creation of pneumoperitoneum, which increases intra-abdominal pressure and affects respiratory system mechanics. These changes can lead to increased peak airway pressure and reduced lung compliance, potentially increasing the risk of ventilator-induced lung injury.

Pressure-regulated volume control (PRVC) ventilation is designed to deliver a set tidal volume with the lowest possible airway pressure by adjusting inspiratory pressure dynamically. However, its performance during laparoscopic procedures and its effect on respiratory mechanics require further evaluation.

This prospective observational study will be conducted on adult patients undergoing elective laparoscopic abdominal surgery under general anesthesia. Standardized anesthesia and ventilation protocols will be applied. Respiratory parameters including peak airway pressure, tidal volume, respiratory rate, and dynamic compliance will be recorded at predefined time points: after induction, after pneumoperitoneum, and at steady-state intraoperative conditions.

The primary outcome will be peak airway pressure. Secondary outcomes include dynamic compliance and other ventilatory parameters. The study aims to enhance understanding of respiratory mechanics during PRVC ventilation and support evidence-based optimization of intraoperative ventilation strategies.

• Study Type: Observational
• Enrollment (Estimated): 52

Contacts and Locations

• Study Contact: Name: Salaheldin A Abdelaziz Ahmed, MD; Phone Number: +201001308006; Email: saladin28.sa@gmail.com

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

Adult patients undergoing elective laparoscopic abdominal surgery under general anesthesia at a tertiary care center.

Description

Inclusion Criteria:

• Adult patients aged 18-65 years
• Scheduled for elective laparoscopic abdominal surgery under general anesthesia
• ASA physical status I-II
• Patients requiring mechanical ventilation using PRVC mode
• Provided informed consent

Exclusion Criteria:

• Patients with significant cardiopulmonary disease
• Chronic obstructive pulmonary disease or restrictive lung disease
• Morbid obesity (BMI > 35 kg/m²)
• Pregnancy
• Emergency surgeries
• Patients with anticipated difficult airway
• Refusal to participate

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Single Cohort; Adult patients undergoing elective laparoscopic abdominal surgery under general anesthesia with pressure-regulated volume control (PRVC) ventilation. Respiratory parameters are recorded at predefined intraoperative time points.	Other: PRVC Ventilation; Mechanical ventilation using pressure-regulated volume control mode applied as part of routine intraoperative anesthesia care. No experimental intervention is introduced.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Peak Airway Pressure	Peak airway pressure (PIP) measured intraoperatively using the anesthesia workstation under standardized pressure-regulated volume control ventilation settings.	At 0, 5, and 10 minutes intraoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dynamic Compliance	Dynamic lung compliance (Cdyn) measured intraoperatively using standard anesthesia monitoring at predefined time points.	At 0, 5, and 10 minutes intraoperatively
Plateau Pressure	Plateau pressure (Pplat) measured during controlled ventilation using the anesthesia workstation.	At 0, 5, and 10 minutes intraoperatively
End-tidal Carbon Dioxide	End-tidal carbon dioxide (EtCO2) measured continuously during mechanical ventilation.	At 0, 5, and 10 minutes intraoperatively
Mean Airway Pressure	Mean airway pressure measured intraoperatively using the anesthesia workstation.	At 0, 5, and 10 minutes intraoperatively
Oxygen Saturation	Peripheral oxygen saturation (SpO2) monitored continuously during surgery.	At 0, 5, and 10 minutes intraoperatively
Heart Rate (beats/min)	Heart rate measured intraoperatively using standard monitoring	At 0, 5, and 10 minutes intraoperatively
Mean Arterial Pressure (mmHg)	Mean arterial pressure measured intraoperatively using standard monitoring	At 0, 5, and 10 minutes intraoperatively
Minute Ventilation	Minute ventilation recorded from the anesthesia workstation during controlled ventilation.	At 0, 5, and 10 minutes intraoperatively

Collaborators and Investigators

• Sponsor: Specialized Medical Center (SMC)
• Investigators: Principal Investigator: Salaheldin A Abdelaziz Ahmed, MD, Specialized Medical Center (SMC), Riyadh, Saudi Arabia

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: April 13, 2026
• First Submitted That Met QC Criteria: April 18, 2026
• First Posted (Actual): April 22, 2026

Study Record Updates

• Last Update Posted (Actual): April 22, 2026
• Last Update Submitted That Met QC Criteria: April 18, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Laparoscopic surgery; Mechanical ventilation; General anesthesia; Peak airway pressure; PRVC ventilation; Dynamic compliance
• Other Study ID Numbers: IRB-002-2026

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No, individual participant data (IPD) will not be shared.

Drug and device information, study documents

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