Surgery Clinical Trial
Postoperative respiratory failure, particularly after surgery under general anesthesia, adds
to the morbidity and mortality of surgical patients. Anesthesiologists inconsistently use
positive end-expiratory pressure (PEEP) and recruitment maneuvers in the hope that this may
improve oxygenation and protect against postoperative pulmonary complications (PPCs),
especially in obese patients. While anesthesiologists tend to use PEEP higher than in
non-obese patients. While it is uncertain whether a strategy that uses higher levels of PEEP
with recruitment maneuvers truly prevents PPCs in these patients, use of higher levels of
PEEP with recruitment maneuvers could compromise intra-operative hemodynamics.
The investigators aim to compare a ventilation strategy using higher levels of PEEP with
recruitment maneuvers with one using lower levels of PEEP without recruitment maneuvers in
obese patients at an intermediate-to-high risk for PPCs.
We hypothesize that an intra-operative ventilation strategy using higher levels of PEEP and
recruitment maneuvers, as compared to ventilation with lower levels of PEEP without
recruitment maneuvers, prevents PPCs in obese patients at an intermediate-to-high risk for
PPC.
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