Peep Titration in Lung Protective Ventilation

The aim of this randomized interventional multi-center clinical trial is to determine whether a standardized lung volume optimization maneuver (LVOM), including PEEP titration, improves outcomes in children undergoing biventricular repair for congenital heart disease (CHD) with cardiopulmonary bypass. The primary hypothesis is that optimizing end-expiratory lung volume through a standardized PEEP titration maneuver improves cardiac performance and lung function. Secondary objectives are to evaluate whether this strategy reduces duration of mechanical ventilation, improves hemodynamics and ventilation-perfusion matching, and decreases the need for vasopressor support.

Our aim in this study is to compare fixed and individualized PEEP (driving pressure guided ) application for intraoperative lung protective ventilation in patients undergoing on-pump CABG surgery. Researcher aimed to compare the effects of two different PEEP application methods on intraoperative hemodynamics, respiratory mechanics, and gas exchange, as well as postoperative extubation times, respiratory complications (atelectasis, need for non invasive mechanical ventilatıon, need for re-entubatıon) length of stay in the intensive care unit, and discharge times.