Morbidly obese patients undergoing laparoscopic bariatric surgery face significant challenges related to intraoperative atelectasis, reduced compliance, and impaired oxygenation. This randomized controlled study compared conventional lung-protective ventilation with a driving pressure–guided strategy, where PEEP was individualized to achieve the lowest possible driving pressure. Patients receiving DP-guided ventilation demonstrated superior oxygenation (PaO₂/FiO₂), improved compliance, and reduced plateau pressures both intraoperatively and post-extubation.
Importantly, the incidence of intraoperative and postoperative hypoxia was markedly lower in the DP-guided group, reinforcing the physiological benefit of pressure-optimized ventilation. These findings highlight the strong potential of driving pressure as a precision metric in tailoring ventilation for high-risk obese patients. To…
