Cardiothoracic & vascular anesthesia
Effects of Individualized Positive End-Expiratory Pressure on Patients Undergoing One-Lung Ventilation During Thoracic Surgery: A Systematic Review and Meta-Analysis
Pooled result · 5 studies (1,814 patients)Result — go to the resultRelative risk 0.78 95% CI 0.59–1.03Authors' conclusion
Individualized PEEP in thoracic surgery may improve intraoperative oxygenation, pulmonary mechanics, and reduce postoperative ARDS but does not significantly lower overall PPCs.
Study context
- Population
- Patients undergoing one-lung ventilation (OLV) during thoracic surgery
- Participants
- 1,844 patients · 6 randomized controlled trials (RCTs)
- Comparison
- Individualized positive end-expiratory pressure (PEEP) vs fixed PEEP during OLV
- Outcome
- Overall postoperative pulmonary complications (PPCs)
- Follow-up
- During hospitalization
Methodological detailstrial sequential analysis, DerSimonian-Laird method, Cochrane Risk of Bias tool version 2
- Trial sequential analysis
- DerSimonian-Laird method
- Cochrane Risk of Bias tool version 2
Pooled result
5 studies (1,814 patients)
Relative risk
0.78
95% CI 0.59–1.03
P = 0.08
Individualized PEEP vs Fixed PEEP
RR 0.78 (95% CI 0.59–1.03); P = 0.08
As reported in the abstract
Further pooled results
Hypoxemia, pneumonia, atelectasis
- Not significantly reduced by individualized PEEP
Postoperative acute respiratory distress syndrome (ARDS)
- Reduced with individualized PEEP
Intraoperative oxygenation and lung compliance
- Improved with individualized PEEP
Original publication
Effects of Individualized Positive End-Expiratory Pressure on Patients Undergoing One-Lung Ventilation During Thoracic Surgery: A Systematic Review and Meta-Analysis. J Cardiothorac Vasc Anesth. Published 11 July 2025. doi:10.
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