Use of Airway Pressure Release Ventilation in Morbidly Obese Patients Undergoing Open Heart Surgery

The goal of this Randomized Clinical trial is to to investigate if the use of Air Pressure Release Ventilation in morbidly obese patients undergoing open heart surgery will improve post operative pulmonary outcomes 60 Patients will be randomized into two groups according to the mode of ventilation used into: Group A: airway pressure release ventilation (APRV) group (30 Patients) Group B: Standard (control) group (30 Patients) Post-operatively, Patients will be ventilated with conventional Synchronized Intermittent Mandatory Ventilation (SIMV) volume control mode

Inclusion Criteria:Age ≥18 y.Scheduled for open heart Surgery with cardiopulmonary bypass (CPB) pump.Class III Obesity (Morbid obesity): BMI ≥ 40.0 kg/m².Exclusion Criteria:Patients with obstructive lung disease (asthma or chronic obstructive pulmonary disease).Pneumothorax or Surgical emphysema.Mechanical ventilation prior to the operation.Patient Refusal.