PROVE Network - flow–controlled ventilation

flow–controlled ventilation

connect with Timur Yurttas or Marcus Schultz for general inquiries about the featured projects

flow–controlled ventilation in complex scenarios – improving intraoperative ventilation and outcomes

in the operating room, anesthesiologists ventilate patients during challenging procedures, such as minimally invasive abdominal surgery, bariatric surgery, or thoracic surgery with one–lung ventilation; flow–controlled ventilation generates smooth linear pressure changes with constant inspiratory and expiratory flow, keeping the lung open at end expiration and reducing mechanical stress; small studies have shown physiologic benefits and optimized ventilation; we conduct international multicenter pilot trials to test the safety and feasibility of flow–controlled ventilation, and larger trials on its impact on postoperative pulmonary complications

[1] PROFLOW–ROBOTic pilot

this international multicenter randomized clinical pilot trial will compare flow–controlled ventilation with pressure–controlled ventilation in patients scheduled for robot–assisted laparoscopic abdominal, urologic, or gynecologic surgery

the objectives are to assess the safety of flow–controlled ventilation and the feasibility of the study, while also informing the design of a future trial, named ‘PROtective ventilation with FLOW–controlled ventilation to improve postoperative pulmonary outcome after ROBOT–assisted laparoscopic surgery’ (PROFLOW–ROBOTic)

this pilot study is registered at clinicaltrials (NCT06703814); the study protocol will be published soon, and patient enrollment is set to begin in February 2025

[2] PROFLOW–ROBOTic

the ‘PROtective ventilation with FLOW–controlled ventilation to improve postoperative pulmonary outcome after ROBOT–assisted laparoscopic surgery’ (PROFLOW–ROBOTic) international multicenter randomized clinical trial determines the effect of flow–controlled ventilation versus conventional ventilation on postoperative pulmonary complications in patients at high risk for postoperative pulmonary complications receiving mechanical ventilation during general anesthesia for laparoscopic robotic–assisted surgery

PROFLOW–ROBOTic will be registered at clinicaltrials (pending); the study protocol will be published in TRIALS

the database of PROFLOW–ROBOTic will be harmonized to enable pooling with data from other flow–controlled studies

for more information visit the PROFLOW–ROBOTic website (available soon)

[3] PROFLOW–THORACic pilot

we are currently planning a pilot study similar to the PROFLOW–ROBOTic pilot, in patients scheduled for open or video–assisted thoracic surgery with one–lung ventilation

this pilot study will be registered at clinicaltrials (pending); the study protocol will also be published soon, and patient enrollment is set to begin in early 2026

[4] PROFLOW–THORACic

the ‘PROtective ventilation with FLOW–controlled ventilation to improve postoperative pulmonary outcome after THORACic surgery’ (PROFLOW–THORACic) international multicenter randomized clinical trial determines the effect of flow–controlled ventilation versus conventional ventilation on postoperative pulmonary complications in patients scheduled for open or video–assisted thoracic surgery with one–lung ventilation

PROFLOW–THORACic will be registered at clinicaltrials (pending); the study protocol will be published in TRIALS

the database of PROFLOW–THORACic will be harmonized to enable pooling with data from other flow–controlled studies

for more information visit the PROFLOW–THORACic website (available soon)

[5] PrECiSIOn

all studies of flow–controlled ventilation will use 'postoperative pulmonary complications' as the primary endpoint; a new composite definition of 'postoperative pulmonary complications' is currently being developed and will be applied in these trials

'Postoperative pulmonary complications – Evaluation for Consensus on StandardIzed Outcomes' (PrECiSIOn), is a Delphi project designed to identify current insights into how postoperative pulmonary complications should be defined and graded

the Delphi is registered at clinicaltrials (NCT06916598); the study protocol was published in British Medical Journal Open (2025; 15:e103888)

the Delphi process has begun recently

connect with Sabrine Hemmes, Timur Yurttas, or Prashant Nasa for information on this Delphi

[6] case series & physiologic studies

the PRotective VEntilation Network aims to provide deeper insight into the settings and direct effects of flow–controlled ventilation.

this includes detailed descriptions of ventilator settings across different types of ventilation, such as in extreme scenarios like minimally invasive laparoscopic surgery or bariatric surgery, as well as in special conditions like one–lung ventilation during thoracic surgery

after ethical approval and informed consent, series of patients will be formed and reported; advanced imaging techniques will be applied to visualize the distribution of ventilation with this mode of ventilation

connect with us if you want to join one of the running studies

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