Here is the design of a clinical trial:

Official Title: An Anesthesia-Centered Bundle to Reduce Postoperative Pulmonary Complications: The PRIME-AIR Study

Included conditions:
- Postoperative Pulmonary Complications

Study Armgroups:
- {'label': 'Usual Care', 'type': 'NO_INTERVENTION', 'description': 'Participants in this arm will receive usual anesthetic and postoperative care as provided in each site.'}
- {'label': 'Intervention', 'type': 'EXPERIMENTAL', 'description': 'This arm will receive the bundle of interventions.', 'interventionNames': ['Other: Preoperative Education', 'Procedure: Intraoperative PEEP (Positive End-Expiratory Pressure) Individualization', 'Other: Individualization of Neuromuscular Blockade', 'Procedure: Postoperative Incentive Spirometry', 'Behavioral: Postoperative Ambulation']}

Interventions:
- {'type': 'OTHER', 'name': 'Preoperative Education', 'description': 'Brochure and video about relevance of postoperative pulmonary complications, postoperative mobilization and use of incentive spirometry.', 'armGroupLabels': ['Intervention']}
- {'type': 'PROCEDURE', 'name': 'Intraoperative PEEP (Positive End-Expiratory Pressure) Individualization', 'description': 'PEEP will be set by maximizing respiratory system compliance along a decremental PEEP titration following an incremental recruitment maneuver.', 'armGroupLabels': ['Intervention']}
- {'type': 'OTHER', 'name': 'Individualization of Neuromuscular Blockade', 'description': 'Administration of neuromuscular blocking agents and their reversal will be done based on established protocol.', 'armGroupLabels': ['Intervention']}
- {'type': 'PROCEDURE', 'name': 'Postoperative Incentive Spirometry', 'description': 'Participants will be encouraged to adhere to incentive spirometry to be started 2 hours after surgery and maintained until participant freely ambulates. Supervision will be provided 3 times/day for continuous education and management of barriers to optimal performance.', 'armGroupLabels': ['Intervention']}
- {'type': 'BEHAVIORAL', 'name': 'Postoperative Ambulation', 'description': 'Participants will be encouraged to adhere to prescription of early ambulation.', 'armGroupLabels': ['Intervention']}

Primary Outcomes:
- {'measure': 'Number and Severity of Postoperative Pulmonary Complications between Participant Groups', 'description': 'The distribution of the number and severity of post-operative pulmonary complications (PPCs) between the control and intervention groups during the first 7 days after surgery.', 'timeFrame': 'Postoperative Days 0 through 7'}

Please estimate the sample size based on the assumption: 
The study assumes a significance level (Î±) of 0.05 (two-sided) and a power of 93%. The distribution of PPC severity among participants with PPCs is assumed to be 50% grade 1, 25% grade 2, 20% grade 3, and 5% grade 4.
Sample size
        Sample size was estimated using simulations of the primary analysis of the distribution of highest PPC severity between the two groups. Based on these simulations, our sample size of 375/group (750 total) being studied has 93% power (Î± = 0.05, two-sided) for the primary analysis for the study. We formulated the treatment effect in this project as a relative percent reduction in PPC rate between groups, not an absolute difference between the two groups. For simplicity in these simulations, we assumed no change in the distribution of the severity of PPCs, so the reduction in PPC rate applied to the number of PPCs of each severity grade. The number of participants without any PPC (highest severity PPC grade 0) was then adjusted accordingly. We then assumed a PPC event rate in the usual care group of 40% [7, 14, 19, 34], and a treatment effect (relative reduction of PPC rate) of 35.29% (so an absolute PPC event rate of 25.88% in the group receiving the intervention bundle). The 35.29% reduction in the rate of any PPCs was the lower 10% bound (one-sided) of the highest posterior region based on previous studies using a Bayesian analysis. This means that we have a 90% expectation that the true treatment effect (reduction in the overall rate of PPCs) of the entire bundle would be greater than 35.29%. We assumed for the simulations that among participants with PPCs, approximately 50% would be grade 1, 25% grade 2, 20% grade 3, and 5% grade 4.