An interventional study of Lung Ultrasound - guided Stepwise PEEP and Standard Ventilation Protocol in Prostate Cancer, Urinary Bladder Cancer and Surgery, sponsored by Nazmy Edward Seif. Active, not recruiting at 1 site in Egypt. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-03-18.
Sponsored by Nazmy Edward Seif · Not applicable, Interventional, and Supportive care
There is an increasing trend in the use of robotic-assisted radical prostatectomy or cystectomy (RARPC).
Preventing lung atelectasis without inducing overdistention of the lung is challenging. Many studies tried to optimize PEEP titration by using methods such as dead space fraction guided and static pulmonary compliance directed techniques, or by using electrical impedance tomography. However, the use of these methods is limited by inaccuracy and the need for sophisticated devices.
Bedside Lung ultrasound is fast, easy and economic technique that is gaining interest in the operating room. Ultrasound-guided PEEP titration has been used in bariatric surgeries (different position and usually shorter procedure time) and proved effective in improving oxygenation, compliance and reducing the incidence of postoperative pulmonary atelectasis and hypoxia without causing hemodynamic instability.
The aim of this study is to evaluate the effectiveness of intraoperative individualized lung ultrasound-guided stepwise PEEP optimization in patients undergoing RARPC on oxygenation, intraoperative and early postoperative pulmonary complications.
Exclusion Criteria:
Lung Ultrasound - guided Positive End Expiratory Pressure group
Procedure: Lung Ultrasound - guided Stepwise PEEP · Procedure: Standard Ventilation Protocol
Standard Ventilation group
Procedure: Standard Ventilation Protocol
After endo-tracheal intubation; A PEEP of 4 cmH2O will be initially used till 5 min after pneumoperitoneum. Then The PEEP will be adjusted in a stepwise approach after performing bedside lung ultrasound. The PEEP will be increased by 2 cmH2O until no lung collapse is detected. Lung ultrasound will be repeated 5 min after every change in the PEEP with a maximal PEEP of 12 cmH2O.
Volume-controlled ventilation (VCV) mode; with a tidal volume of 6 mL/kg of ideal weight, inspiratory : expiratory ratio 1: 2, PEEP 4 cmH2O, respiratory rate adjusted to keep end-tidal carbon dioxide tension (EtCO2) between 35 and 40 mm Hg, and inspired oxygen fraction of 50%.
Post-operative lung consolidation
Presence (or not) of post-operative lung consolidation detected by lung ultrasound.
Time frame: 24 hours
This study is active, not recruiting, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.
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Nazmy Edward Seif