The purpose of this study is to compare two different airway pressure (PEEP) strategies during gynecological laparoscopic surgery to see which one better prevents lung collapse (atelectasis). We will compare a 'standard' fixed pressure with a 'personalized' pressure adjusted according to the patient's own lung mechanics (driving pressure). We will use lung ultrasound to check the lungs before surgery, 1 hour after surgery, and 24 hours after surgery to evaluate the results.
Eligibility
Sex
FEMALE
Min age
18 Years
Max age
65 Years
Healthy volunteers
No
Inclusion Criteria:
* Female patients aged between 18 and 65 years.
* American Society of Anesthesiologists (ASA) physical status I, II, or III.
* Scheduled for elective laparoscopic gynecological surgery (e.g., hysterectomy, myomectomy, sacrocolpopexy).
* Planned to undergo general anesthesia with endotracheal intubation.
* Expected surgery duration of 2 hours or more.
* Body Mass Index (BMI) ≤ 35 kg/m².
Exclusion Criteria:
* History of moderate-to-severe Chronic Obstructive Pulmonary Disease (COPD), clinically significant interstitial lung disease, or severe restrictive lung disease.
* New York Heart Association (NYHA) class III-IV heart failure, Ejection Fraction (EF) \< 35%, or severe valvular disease.
* Advanced arrhythmia or hemodynamic instability (requiring high-dose vasopressor support).
* History of respiratory failure requiring mechanical ventilation within the past 4 weeks.
* Clinically or radiologically confirmed lower respiratory tract infection (e.g., pneumonia) within the past 1 month.
* Presence of thoracic deformity, large surgical dressings, severe subcutaneous emphysema, or any condition that hinders lung ultrasound evaluation.
* Pre-existing significant atelectasis or lung consolidation (defined as a score of 3 for consolidation or ≥2 zones with a score of ≥2 on preoperative LUS).
* Expected inability to perform the 24-hour postoperative ultrasound measurement (e.g., due to early discharge).
Primary outcome measure(s)
Lung Ultrasonography (LUS) Score — Preoperatively (baseline), 1 hour postoperatively, and 24 hours postoperatively. Atelectasis severity is assessed using a 12-zone Lung Ultrasonography (LUS) scoring system. Each zone is scored from 0 to 3 (0=normal aeration, 3=consolidation). The total score ranges from 0 to 36. Higher scores indicate worse lung aeration and more severe atelectasis.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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