Mechanical Power During Different Ventilation Modes in Laparoscopic Surgery

NCT07670494 — Not applicable, Recruiting, 80 participants, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

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Comparison of Mechanical Power in Pressure-Regulated Volume Control and Volume-Controlled Ventilation Modes During Laparoscopic Cholecystectomy

Registry	NCT07670494
Status	Recruiting
Phase	Not applicable
Study type	Interventional; randomized, crossover, masking: single, basic science
Enrollment	80 (Estimated)
Sponsor	Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital (Other)
Conditions	Laparoscopic Cholecystectomy, Mechanical Ventilation, Ventilator-Induced Lung Injury
Interventions	Volume-Controlled Ventilation (VCV), Pressure-Regulated Volume Control (PRVC) (Device)
Dates	start 2026-07-01, primary completion 2026-08-10 (estimated), completion 2026-08-12 (estimated), first posted 2026-06-26, last updated 2026-07-08
Locations	1 site in Turkey (Türkiye)

-Summary

This study investigates how different breathing machine (ventilator) settings affect the energy delivered to the lungs during surgery. Mechanical power is a measure of this energy, and high levels can sometimes lead to lung irritation. In clinical practice, a mode called Pressure-Regulated Volume Control (PRVC) is often used because it lowers the "peak" pressure in the airways, which is generally thought to be safer. However, doctors have noticed that even though the peak pressure goes down in PRVC mode, the total mechanical power displayed on the monitor might actually increase compared to the standard Volume-Controlled Ventilation (VCV) mode. In this study, patients undergoing gallbladder surgery will be monitored using both ventilation modes in a random order. The researchers will compare the machine-calculated mechanical power for both modes to see if the perceived benefit of lower peak pressure in PRVC actually results in lower overall energy transfer to the lungs.

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+Arms and interventions

Arm	Type	Interventions	Description
group A; VCV First, Then PRVC	Experimental	Device: Volume-Controlled Ventilation (VCV); Device: Pressure-Regulated Volume Control (PRVC)	Following the stabilization of pneumoperitoneum, participants will be ventilated using the Volume-Controlled Ventilation (VCV) mode for 10 minutes. At the end of this period, respiratory data and mechanical power values will be recorded. Immediately after, the ventilator will be switched to the Pressure-Regulated Volume Control (PRVC) mode with equivalent settings. After another 10-minute stabilization period in PRVC mode, a second set of measurements will be recorded.
group B; PRVC First, Then VCV	Experimental	Device: Volume-Controlled Ventilation (VCV); Device: Pressure-Regulated Volume Control (PRVC)	Following the stabilization of pneumoperitoneum, participants will be ventilated using the Pressure-Regulated Volume Control (PRVC) mode for 10 minutes. At the end of this period, respiratory data and mechanical power values will be recorded. Immediately after, the ventilator will be switched to the Volume-Controlled Ventilation (VCV) mode with equivalent settings. After another 10-minute stabilization period in VCV mode, a second set of measurements will be recorded.

Volume-Controlled Ventilation (VCV) (Device): Participants will be ventilated with the traditional Volume-Controlled Ventilation (VCV) mode. Tidal volume, respiratory rate, PEEP, and I:E ratio will be set according to the study protocol and kept constant during the measurement period.
Pressure-Regulated Volume Control (PRVC) (Device): Participants will be ventilated with the Pressure-Regulated Volume Control (PRVC) mode. This is a hybrid mode that uses a decelerating flow to deliver the target tidal volume at the lowest possible pressure. Settings will be identical to the VCV mode for each patient.

+Outcome measures

Primary outcomes

Device-Displayed Mechanical Power [At the end of a 10-minute stabilization period in each ventilation mode (VCV and PRVC).]: The mechanical power value (expressed in Joules per minute - J/min) is automatically calculated and displayed on the monitor of the Mindray A9 anesthesia machine. This value represents the total energy delivered by the ventilator to the patient's respiratory system per minute. The study aims to compare how this machine-calculated value differs between the Volume-Controlled Ventilation (VCV) and Pressure-Regulated Volume Control (PRVC) modes under identical clinical conditions.

+Eligibility

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Patients undergoing elective laparoscopic cholecystectomy surgery.
* Patients between 18 and 75 years of age.
* American Society of Anesthesiologists (ASA) physical status I, II or III.
* Body Mass Index (BMI) between 18.5 and 35 kg/m².
* Voluntary written informed consent for participation.

Exclusion Criteria:

* History of significant chronic obstructive pulmonary disease (COPD) or asthma.
* Previous lung resection or major thoracic surgery.
* Heavy smokers (more than 20 cigarettes per day).
* Presence of spontaneous breathing effort during mechanical ventilation.
* Conversion from laparoscopic surgery to open surgery during the procedure.
* Emergency surgery cases.
* Known pregnancy.

+Locations (1)

Facility	City	Country	Status
Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital	Yenimahalle, Ankara	Turkey (Türkiye)	Recruiting