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COMPLETED
NCT04408495
NA

Intraoperative Mechanical Ventilation and Postoperative Pulmonary Complications After On-pump Cardiac Surgery in High-risk Patients

Sponsor: Rennes University Hospital

View on ClinicalTrials.gov

Summary

Controversies remain concerning the best intraoperative mechanical ventilation regimen for major cardiac surgery. While the use of intra operative low tidal volumes is now standard practice, the optimal level of positive end-expiratory pressure (PEEP) and the use of recruitment maneuvers (RM) remain controversial. The aim of this study is to compare two regimens of intraoperative mechanical ventilation on postoperative outcomes in cardiac surgery patients at risk of postoperative pulmonary complications

Official title: Effect of IntraoperatiVe High Positive End-ExpirAtory Pressure (PEEP) With ReCruitment MAneuveRs vs Low PEEP on Major Postoperative Pulmonary Complications and Death After On-pump Cardiac Surgery in High-risk Patients: the VACARM Study

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

441

Start Date

2021-07-08

Completion Date

2025-09-16

Last Updated

2026-04-08

Healthy Volunteers

No

Interventions

PROCEDURE

Intervention group_MRA

Tidal Volume (Vt) =6-8 mL/kg of predicted body weight (PBW), Peep=8 cmH2O, recruitment maneuvers=30cm H2O every 30 min after intubation (except during CPB), after any disconnection and at the admission in ICU. Recruitment maneuvers are performed in accordance with the surgical team an if SAP≥90 mmHg or MAP≥65 mmHg. Ventilation is maintained during CPB Vt=2.5 mL/kg, Peep= 5 cmH2O

PROCEDURE

Control group

Vt=6-8 mL/kg of PBW, Peep=5 cmH2O , No recruitment maneuvers. Ventilation maintained during CPB Vt=2.5 mL/kg, Peep= 5 cmH2O.

Locations (10)

CHU Amiens-Picardie

Amiens, France

CHRU Brest

Brest, France

CHU de Dijon

Dijon, France

CHU de Nancy

Nancy, France

CHU Poitiers

Poitiers, France

CHU Rennes

Rennes, France

CHU de Rouen

Rouen, France

CHU Nantes

Saint-Herblain, France

CHU de Toulouse

Toulouse, France

CHRU Tours

Tours, France