Perioperative medicine & outcomes
Association between driving pressure-guided ventilation and postoperative pulmonary complications in surgical patients: a meta-analysis with trial sequential analysis
Pooled result · As indicated by TSAResult — go to the resultRelative risk 0.70 95% CI 0.56–0.87Authors' conclusion
Driving pressure-guided ventilation was associated with a lower risk of postoperative pulmonary complications in non-cardiothoracic surgery but not in cardiothoracic surgery.
Study context
- Population
- Adult surgical patients
- Participants
- 3,401 patients · 13 RCTs
- Comparison
- Driving pressure-guided ventilation vs conventional protective ventilation
- Outcome
- Composite of PPCs
Methodological detailstrial sequential analysis, subgroup analysis
- Trial sequential analysis
- Subgroup analysis
Pooled result
As indicated by trial sequential analysis (TSA)
Relative risk
0.70
95% CI 0.56–0.87
P = 0.001
Driving pressure-guided ventilation vs Conventional protective ventilation
RR 0.70 (95% CI 0.56–0.87); P = 0.001
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| PPCs, non-cardiothoracic surgery (subgroup; 9 RCTs, 1038 subjects)TSA: sufficient evidence, conclusive result | 0.61 (0.48–0.77) | P < 0.0001 | |
| PPCs, cardiothoracic surgery (subgroup; 4 RCTs, 2363 subjects)TSA: insufficient evidence, inconclusive result | 0.86 (0.67–1.10) | P = 0.23 | |
| 0.512Relative risk (log scale) |
- Postoperative pulmonary complications (PPCs), non-cardiothoracic surgery (subgroup; 9 RCTs, 1038 subjects): P for interaction=0.04
- PPCs, cardiothoracic surgery (subgroup; 4 RCTs, 2363 subjects): P for interaction=0.04
Pneumonia (by surgery subgroup)
- Lower risk of pneumonia in non-cardiothoracic but not in cardiothoracic surgery
- P for interaction=0.046
Atelectasis and ARDS
- No significant differences between the two ventilation strategies
Original publication
Association between driving pressure-guided ventilation and postoperative pulmonary complications in surgical patients: a meta-analysis with trial sequential analysis. Br J Anaesth. Published 26 June 2024. doi:10.
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