Trial reportBMC anesthesiology2025
Driving pressure guided ventilation versus conventional lung protective strategy in morbid obese patients undergoing laparoscopic bariatric surgery: a prospective randomized controlled study.
Trial report in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04861168 (Driving Pressure Guided Ventilation Versus Conventional Lung Protective Strategy in Morbid Obese Patients Undergoing Laparoscopic Bariatric Surgery; a Prospective Randomized Controlled Study), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Driving Pressure Guided Ventilation Versus Conventional Lung Protective Strategy in Morbid Obese Patients Undergoing Laparoscopic Bariatric Surgery; a Prospective Randomized Controlled Study
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Non-drug perioperative interventions to reduce postoperative pulmonary complications after abdominal surgery: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2026Pooled it
- Driving pressure-guided individualized PEEP versus fixed low PEEP in obese patients undergoing bariatric surgery: a randomized clinical trial.Journal of anesthesia · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMechanical ventilation in bariatric surgery presents unique challenges, requiring strategies that minimize intraoperative atelectasis, maintain adequate oxygenation, and lower the risk of postoperative pulmonary complications. The present study compared driving pressure-guided ventilation with conventional lung-protective ventilation in morbidly obese patients undergoing laparoscopic bariatric surgery.
methodsSixty patients with a body mass index (BMI) of 40-50 kg/m², scheduled for laparoscopic bariatric surgery, were randomized according to intraoperative ventilation strategy into two groups: Group I (n = 30) received the conventional lung-protective strategy, and Group II (n = 30) received the driving pressure-guided ventilation strategy. After induction of pneumoperitoneum, a standardized lung recruitment maneuver was performed, after which ventilation strategies were applied according to group allocation: in Group I, positive end-expiratory pressure (PEEP) was maintained at 5 cmH₂O throughout surgery, whereas in Group II, PEEP was individualized to achieve the lowest driving pressure (DP).
resultsThe PaO₂/FiO₂ ratio showed significant improvement after the recruitment maneuver in both groups compared with baseline values. However, measurements obtained before the end of surgery and after extubation were significantly higher in Group II than in Group I (P < 0.001). Lung mechanics were also significantly better in Group II, with higher compliance, lower driving pressure, and reduced plateau pressure (Pplat). Intraoperative hypoxia requiring rescue therapy occurred in 10 patients (33.3%) in Group I compared with 2 patients (6.7%) in Group II, while postoperative hypoxia requiring supplementary oxygen was observed in 7 patients (23.3%) in Group I and in none of the patients in Group II.
conclusionThe adoption of driving pressure-based ventilation in laparoscopic bariatric surgery for morbidly obese patients was associated with improved oxygenation, optimized lung mechanics, and a lower risk of postoperative hypoxemia.
trial registrationThe trial was registered prior to patient enrolment at ClinicalTrials.gov (NCT04861168, Date of registration: 27/4/2021).
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