Prevalence and Clinical Impact of Airway Opening Pressure in Post-Cardiac Surgery Patients

Not Applicable

Active, not recruiting

• Conditions: Cardiac Surgery; Mechanical Ventilation After Surgery

• Registration Number: NCT07189026
• Lead Sponsor: Laval University

Brief Summary

Airway opening pressure is a key parameter in assessing respiratory mechanics. Current practice primarily relies on indirect assessments of lung mechanics, but growing evidence suggests that direct airway opening pressure measurement could enhance individualized ventilatory strategies. Significant airway opening pressure suggests incomplete alveolar recruitment at end-expiration, which may contribute to ventilation-perfusion mismatch, increased respiratory effort, and postoperative pulmonary complications such as atelectasis and impaired gas exchange. Determining the prevalence and clinical relevance of significant airway opening pressure in post-cardiac surgery patients could contribute to more personalized respiratory strategies and improve postoperative care.

Detailed Description

Not available

Study Timeline

• Study Start: 2025-06-27
• Study First Submitted: 2025-08-27
• Status Verified: 2025-09
• Study First Submitted QC: 2025-09-16
• Last Update Submitted: 2025-09-16
• Study First Posted: 2025-09-23
• Last Update Posted: 2025-09-23
• Primary Completion: 2026-12
• Study Completion: 2027-06-01

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 196

Inclusion Criteria

• Adult (≥18 years)
• Undergoing elective coronary artery bypass grafting (CABG) or valve surgery, or combined procedures with expected postoperative mechanical ventilation

Exclusion Criteria

- Patient receiving invasive mechanical ventilation prior to surgery

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Primary Outcome Measures

Name	Time	Method
Prevalence of significant airway opening pressure	up to 1 hour after intensive care admission	airway opening pressure ≥ 5 cmH₂O

Secondary Outcome Measures

Name	Time	Method
Airway opening pressure prevalence based on body mass index	up to 1 hour	Airway opening pressure prevalence base on Obesity status (body mass index ≥30 vs. \<30 kg/m²)
Airway opening pressure prevalence based on cardiopulmonary bypass duration	up to 1 hour	Airway opening pressure prevalence based on cardiopulmonary bypass duration (minutes)
Airway opening pressure prevalence based on left ventricular dysfunction	up to 1 hour	Airway opening pressure prevalence based on left ventricular dysfunction (Ieft ventricular ejection fraction \< 50 percent vs \> 50 percent)
Airway opening pressure prevalence based on inotropic support	up to 1 hour	Airway opening pressure prevalence based on use of amines (\< 0.1 mcg/kg/min or norepinephrine equivalent vs \> 0.1 mcg/kg/min or norepinephrine equivalent)
Airway opening pressure prevalence based on age	up to 1 hour	Airway opening pressure prevalence base on age
Airway opening pressure prevalence based on intraoperative fluid balance	up to 1 hour	Airway opening pressure prevalence base on intraoperative fluid balance
Feasibility of airway opening pressure measurement	up to 1 hour	proportion of patients in whom the maneuver is successfully completed
Positive end expiratory pressure level	up to 1 hour	Number of times Positive end expiratory pressure is set greater than measured airway opening pressure
Extubation	Day7	Correlation between airway opening pressure and time to extubation
Patient position	up to 1 hour	Comparison of airway opening pressure values in flat versus semi-recumbent (30-degree) positions
Hemodynamic tolerance base on blood pressure drop	up to 15 minutes	Evaluation of hemodynamic tolerance based on arterial pressure during positive end-expiratory pressure adjustment (if inotropic agents are required, an increase of more than 0.05 mcg/kg/min in norepinephrine equivalent is considered significant)
Hemodynamic tolerance base on pulse oxygen saturation drop	up to 15 minutes	Evaluation of hemodynamic tolerance based on pulse oxygen saturation. A decrease in pulse oxygen saturation of 5 percent from baseline or more is considered significant.
Non-interruptive airway opening pressure measurement method	up to 1 hour	The novel non-interruptive airway opening pressure measurement method will be validated

Trial Locations

Locations (1)

Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval; 🇨🇦 Québec, Quebec, Canada