Single-step vs Stepwise Lung Recruitment Maneuvers After Cardiopulmonary Bypass
This prospective randomized controlled trial aims to compare the hemodynamic and pulmonary effects of single-step and stepwise lung recruitment maneuvers in adult patients undergoing elective cardiac surgery with cardiopulmonary bypass. After separation from cardiopulmonary bypass, patients will be randomized to receiv
| Condition(s) | Atelectasis, Postoperative |
|---|---|
| Status | Recruiting |
| Phase | NA |
| Study type | Interventional |
| Summary | This prospective randomized controlled trial aims to compare the hemodynamic and pulmonary effects of single-step and stepwise lung recruitment maneuvers in adult patients undergoing elective cardiac surgery with cardiopulmonary bypass. After separation from cardiopulmonary bypass, patients will be randomized to receive either a single-step sustained inflation recruitment maneuver or a stepwise incremental recruitment maneuver, both combined with 8 cmH₂O positive end-expiratory pressure. The primary outcome is the change in cardiac index before and after the recruitment maneuver. Secondary outcomes include lung ultrasound atelectasis score, and hemodynamic parameters. |
| Who can participate | Inclusion Criteria: * Age 18-80 years * ASA (American Society of Anesthesiologists) II-IV * Patients undergoing elective cardiac surgery (coronary artery bypass grafting, mitral valve replacement, aortic valve replacement) Exclusion Criteria: * Emergency surgery * Presence of perioperative arrhythmia * \<35% left ventricular ejection fraction * \>50 mmHg systolic pulmonary artery pressure * Known chronic obstructive pulmonary disease or interstitial lung disease * Pneumothorax * Mean arterial pressure \<60 mmHg during recruitment maneuver * New York Heart Association (NYHA) class III-IV heart failure * Advanced cardiomyopathy or severe mitral regurgitation * Cross-clamp time longer than 2 hours * Requirement for high-dose inotropic or vasopressor support * Patients who cannot be extubated |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Lead sponsor | Ondokuz Mayıs University |
| Locations | Samsun, Atakum, Turkey (Türkiye) |
| Start date | 2026-02-15 |
| NCT ID | NCT07432477 |
| Official listing | https://clinicaltrials.gov/study/NCT07432477 |