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CLINICAL TRIAL article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1537788
This article is part of the Research Topic Advancements in Mechanical Ventilation: Understanding Physiology to Mitigate Complications View all 5 articles
Effect of Individualized End-inspiratory Pause Guided by Driving Pressure on Respiratory Mechanics during Prone Spinal Surgery: a Randomized Controlled Trial
Provisionally accepted- Department of Anesthesiology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
The prone position is commonly used in spinal surgery, but it can lead to decreased lung compliance and increased airway pressure. This study aimed to evaluate the effect of individualized end-inspiratory pause guided by driving pressure on respiratory mechanics in patients undergoing prone spinal surgery.Methods: A randomized controlled trial was conducted from August to October 2023.Patients scheduled for elective prone spinal surgery were randomly assigned to either a study group, receiving individualized end-inspiratory pause, or a control group, receiving a fixed end-inspiratory pause (10% of total inspiratory time). Mechanical ventilation parameters, including tidal volume, plateau pressure, driving pressure and peak pressure were recorded at different time points. Arterial blood gases were collected at baseline and at specified intervals.Results: Data from 36 subjects (18 in each group) were included in the final analysis.The study group exhibited a significant increase in respiratory system compliance (P ＜ 0.05) and improved intraoperative oxygenation (P ＜ 0.05). Additionally, the individualized end-inspiratory pause significantly decreased plateau pressure (P＜ 0.05) and driving pressure (P＜0.05) compared to the control group.The individualized end-inspiratory pause guided by driving pressure effectively optimized pulmonary compliance and improved oxygenation during prone spinal surgery. These findings suggest that this ventilation strategy may enhance respiratory mechanics and reduce the risk of postoperative pulmonary complications.
Keywords: End-inspiratory pause, Driving pressure, Lung protective ventilation strategy, Pulmonary compliance, Prone spinal surgery
Received: 01 Dec 2024; Accepted: 20 Mar 2025.
Copyright: © 2025 Zhang, Lv, He, Zhang, Ren and Jin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Li Ren, Department of Anesthesiology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Juying Jin, Department of Anesthesiology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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