Respiratory failure & ventilation
High Positive End-expiratory Pressure (PEEP) with Recruitment Maneuvers versus Low PEEP during General Anesthesia for Surgery: A Bayesian Individual Patient Data Meta-analysis of Three Randomized Clinical Trials
Authors' conclusion
High PEEP with recruitment maneuvers demonstrated a moderate reduction in the probability of postoperative pulmonary complication occurrence, with a high posterior probability of benefit observed consistently across various prior beliefs, particularly among patients who underwent laparoscopy.
Study context
- Population
- Surgical patients under GA at intermediate to high risk for PPCs3 RCTs
- Comparison
- High PEEP with recruitment maneuvers vs low PEEP
- Outcome
- Occurrence of PPCs
- Follow-up
- Early postoperative period
Methodological detailsmultilevel Bayesian logistic regression, neutral, pessimistic and optimistic priors
- Multilevel Bayesian logistic regression
- Neutral, pessimistic and optimistic priors
Pooled result
As reported in the abstract
High PEEP vs Low PEEPPosterior mean OR (95% CrI)
Neutral prior; CrI
0.85(0.71–1.02)
Pessimistic prior; CrI
0.87(0.72–1.04)
Optimistic prior; CrI
0.86(0.71–1.02)
- Posterior probability of beneficial effect, regardless of prior
- exceeded 90%
Further pooled results
PPCs, laparoscopy (subgroup)
- More pronounced effect in patients who underwent laparoscopy, OR
- 0.67 [0.50 to 0.87] (CrI)
- Bayesian subgroup analysis
PPCs, high risk for PPCs (subgroup)
- More pronounced effect in patients at high risk for PPCs, OR
- 0.80 [0.53 to 1.13] (CrI)
- Bayesian subgroup analysis
Severe PPCs only or different heterogeneity prior (sensitivity analysis)
- Consistent results
Original publication
High Positive End-expiratory Pressure (PEEP) with Recruitment Maneuvers versus Low PEEP during General Anesthesia for Surgery: A Bayesian Individual Patient Data Meta-analysis of Three Randomized Clinical Trials. Anesthesiology. Published 22 July 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →