Effect of Ultra-Low Tidal Volume on Mechanical Power During Heart Bypass Surgery

Summary

The goal of this clinical trial is to evaluate whether ultra-low tidal volume (ULTV) ventilation during cardiopulmonary bypass (CPB) can reduce mechanical power (MP) and improve postoperative respiratory outcomes in adult patients undergoing elective coronary artery bypass graft (CABG) surgery. The main questions it aims to answer are: Does ULTV ventilation during CPB result in lower intraoperative mechanical power compared to apnea? Can ULTV ventilation reduce extubation time and ICU (Intensive Care Unit) stay and improve the PaO₂/FiO₂ ratio (Partial Pressure of Arterial Oxygen / Fraction of Inspired Oxygen Ratio)? Researchers will compare patients receiving ULTV ventilation to those undergoing apnea after aortic cross-clamping to assess the effects on mechanical power and postoperative outcomes. Participants will: Be randomized to either ULTV ventilation or apnea group Undergo standard general anesthesia and CABG surgery Have mechanical power measured at three time points (pre-CPB, post-CPB, and ICU pre-extubation) Have arterial blood gases evaluated for PaO₂/FiO₂ ratios Be monitored for extubation time and ICU length of stay This study aims to generate evidence that could inform safer and more protective intraoperative ventilation strategies during cardiac surgery.

Eligibility

Inclusion Criteria:

* Patients of either sex aged over 18 years
* Patients classified as ASA II-IV
* Patients scheduled for elective CABG

Exclusion Criteria:

* Presence of severe COPD
* Uncontrolled bronchial asthma
* Decompensated heart failure (NYHA class III-IV)
* Pulmonary hypertension
* History of lung surgery
* Morbid obesity (BMI \>35)
* Emergency surgery cases
* Patients who decline to participate in the study

Conditions2

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