Driving Pressure During General Anesthesia for Open Abdominal Surgery

NCT ID: NCT03884543

Last Updated: 2025-11-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1468 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-04-23

Study Completion Date

2025-06-01

Brief Summary

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The purpose of this international multicenter, patient and outcome-assessor blinded randomized controlled trial is to determine whether the application of an individualized high PEEP strategy, aiming at avoiding an increase in the driving pressure during intraoperative ventilation, protects against the development of postoperative pulmonary complications.

Detailed Description

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Conditions

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Postoperative Respiratory Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Individualized high PEEP strategy

Recruitment maneuver (performed after induction of anesthesia, after any disconnection from the mechanical ventilator, and before extubation) followed by the decremental PEEP trial to determine the highest level of PEEP resulting in the lowest driving pressure. This is again followed by a recruitment maneuver, after which PEEP is set at the level indicated by the decremental PEEP trial.

Group Type EXPERIMENTAL

Individualized high PEEP strategy

Intervention Type PROCEDURE

Patients are randomized and intra-operatively ventilated with an individualized high PEEP strategy (Highest PEEP with the lowest driving pressure with recruitment maneuvers)

Standard low PEEP strategy

PEEP at maximum 5cm H2O. No recruitment maneuvers. Patients are randomized and intraoperatively ventilated with conventional strategy. (PEEP at maximum 5cm H2O without recruitment maneuvers)

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Individualized high PEEP strategy

Patients are randomized and intra-operatively ventilated with an individualized high PEEP strategy (Highest PEEP with the lowest driving pressure with recruitment maneuvers)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Scheduled for open abdominal surgery
* High or intermediate risk for postoperative pulmonary complications according to ARISCAT score \[J.Canet et al, Anesthesiology 2010;113\]
* General anesthesia

Exclusion Criteria

* Laparoscopic surgery
* Surgery in prone or lateral position
* Combined procedure with open abdominal and intrathoracic surgery
* Body mass index \> 40 kg/m2;
* Reported pregnancy;
* Mechanical ventilation \> than 30 minutes (e.g., in cases of general anesthesia because of surgery) within last 30 days;
* Any major previous lung surgery;
* History of previous severe chronic obstructive pulmonary disease (COPD) GOLD III or IV, or with (noninvasive) ventilation and/or oxygen therapy at home;
* (previous) acute respiratory distress syndrome (ARDS);
* Expected to require postoperative mechanical ventilation;
* Persistent hemodynamic instability or intractable shock;
* Severe cardiac disease (New York Heart Association class III or IV, or acute coronary syndrome, or persistent ventricular tachyarrhythmia's);
* Consented for another interventional study during anesthesia or refusal to participate in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Amsterdam UMC, location VUmc

OTHER

Sponsor Role collaborator

Noord West Ziekenhuizen location Alkmaar

UNKNOWN

Sponsor Role collaborator

University Medical Center Groningen

OTHER

Sponsor Role collaborator

Radboud University Medical Center

OTHER

Sponsor Role collaborator

HagaZiekenhuis

OTHER

Sponsor Role collaborator

Rijnstate Hospital

OTHER

Sponsor Role collaborator

Medical Center Haaglanden

OTHER

Sponsor Role collaborator

Bernhoven Hospital

OTHER

Sponsor Role collaborator

Onze Lieve Vrouwe Gasthuis

OTHER

Sponsor Role collaborator

Albert Schweitzer Hospital

OTHER

Sponsor Role collaborator

Frisius Medisch Centrum

OTHER

Sponsor Role collaborator

Leiden University Medical Center

OTHER

Sponsor Role collaborator

Maastricht University Medical Center

OTHER

Sponsor Role collaborator

Martini Hospital Groningen

OTHER

Sponsor Role collaborator

Erasmus Medical Center

OTHER

Sponsor Role collaborator

Spaarne Gasthuis

OTHER

Sponsor Role collaborator

University Hospital Carl Gustav Carus

OTHER

Sponsor Role collaborator

Bermanntrost BG Klinikum Halle

UNKNOWN

Sponsor Role collaborator

Heinrich-Heine University, Duesseldorf

OTHER

Sponsor Role collaborator

Ospedale Policlinico San Martino

OTHER

Sponsor Role collaborator

Jeroen Bosch Ziekenhuis

OTHER

Sponsor Role collaborator

Meander Medical Center

OTHER

Sponsor Role collaborator

Isala

OTHER

Sponsor Role collaborator

Alrijne Hospital

OTHER

Sponsor Role collaborator

Antoni van Leeuwenhoek Ziekenhuis

UNKNOWN

Sponsor Role collaborator

Medisch Spectrum Twente

OTHER

Sponsor Role collaborator

Campus Bio-Medico University

OTHER

Sponsor Role collaborator

Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale

NETWORK

Sponsor Role collaborator

University of Roma La Sapienza

OTHER

Sponsor Role collaborator

University of Campania Luigi Vanvitelli

OTHER

Sponsor Role collaborator

Hospital Universitario La Fe

OTHER

Sponsor Role collaborator

Medical University Innsbruck

OTHER

Sponsor Role collaborator

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

OTHER

Sponsor Role lead

Responsible Party

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Prof. Dr. Marcus J. Schultz

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marcus J. Schultz, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Intensive Care

Markus W. Hollmann, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Anesthesiology

Locations

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University hospital Carl Gustav Carus

Dresden, , Germany

Site Status

Heinrich-Heine University Hospital Dusseldorf

Düsseldorf, , Germany

Site Status

Bermanntrost BG Klinikum Halle

Halle, , Germany

Site Status

Ospedale Policlinico San Martino

Genoa, , Italy

Site Status

University hospital Napoli

Napoli, , Italy

Site Status

Noordwest ziekenhuizengroep Alkmaar

Alkmaar, , Netherlands

Site Status

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Amsterdam, , Netherlands

Site Status

Amsterdam UMC location VUmc

Amsterdam, , Netherlands

Site Status

Onze Lieve Vrouwen Gasthuis

Amsterdam, , Netherlands

Site Status

Rijnstate Hospital

Arnhem, , Netherlands

Site Status

Albert Schweitzer Ziekenhuis

Dordrecht, , Netherlands

Site Status

Martini Hospital

Groningen, , Netherlands

Site Status

UMC Groningen

Groningen, , Netherlands

Site Status

Spaarne Gasthuis Hospital

Haarlem, , Netherlands

Site Status

Medical Center Leeuwarden

Leeuwarden, , Netherlands

Site Status

Leiden UMC

Leiden, , Netherlands

Site Status

Maastricht UMC

Maastricht, , Netherlands

Site Status

Radboud UMC

Nijmegen, , Netherlands

Site Status

Erasmus Medisch Centrum

Rotterdam, , Netherlands

Site Status

Haaglanden Medisch Centrum

The Hague, , Netherlands

Site Status

HAGA

The Hague, , Netherlands

Site Status

Bernhoven Hospital

Uden, , Netherlands

Site Status

Countries

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Germany Italy Netherlands

References

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Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A; Acute Kidney Injury Network. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11(2):R31. doi: 10.1186/cc5713.

Reference Type RESULT
PMID: 17331245 (View on PubMed)

DESIGNATION-investigators. Driving Pressure During General Anesthesia for Open Abdominal Surgery (DESIGNATION): study protocol of a randomized clinical trial. Trials. 2020 Feb 18;21(1):198. doi: 10.1186/s13063-020-4075-z.

Reference Type DERIVED
PMID: 32070400 (View on PubMed)

Provided Documents

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Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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DESIGNATION

Identifier Type: -

Identifier Source: org_study_id

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