Respiratory failure & ventilation
Effects of individualised positive end-expiratory pressure titration on respiratory and haemodynamic parameters during the Trendelenburg position with pneumoperitoneum: A randomised crossover physiologic trial
Authors' conclusion
PEEP ΔP ameliorated the effects of Trendelenburg position with pneumoperitoneum during surgery on end-expiratory PTP and lung volume, decreased driving pressure and dynamic elastic power, as well as improved gas-exchange while preserving cardiac output.
Study context
- Population
- Patients undergoing robot-assisted laparoscopic radical prostatectomy in Trendelenburg position with pneumoperitoneum, university hospitalcrossover, all strategies
- Participants
- 36 patients
- Comparison
- Positive end-expiratory pressure (PEEP) titrated to minimal driving pressure (PEEP ΔP) or oesophageal pressure-guided (PEEP Poeso) vs standard PEEP 5 cmH2O
- Primary endpoint
- Set PEEP level with PEEP ΔP and PEEP Poeso vs PEEP 5 cmH2O
Methodological detailsprospective, single-centre
- Prospective
- Single-centre
Primary result
As reported in the abstract
PEEP level
P < 0.001
Secondary outcomes
| Outcome | P value |
|---|---|
| End-expiratory PTP and lung volumePEEP ΔP vs PEEP Poeso · end-expiratory PTP, lower with PEEP ΔP | P = 0.014 |
| End-expiratory PTP and lung volumePEEP ΔP vs PEEP Poeso · lung volume, lower with PEEP ΔP | P < 0.001 |
Driving pressure, lung stress, respiratory system and dynamic elastic power
- Minimised using PEEP ΔP
- P < 0.001
- P < 0.001 each
Gas exchange
- Improved with PEEP ΔP and PEEP Poeso
Safety
Cardiac output
- Lower with PEEP Poeso vs PEEP 5 and PEEP ΔP
Original publication
Effects of individualised positive end-expiratory pressure titration on respiratory and haemodynamic parameters during the Trendelenburg position with pneumoperitoneum: A randomised crossover physiologic trial. Eur J Anaesthesiol. Published 30 August 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →