Cardiothoracic & vascular anesthesia
Individualized positive end-expiratory pressure (PEEP) titration by lung compliance during one-lung ventilation: a meta-analysis
Pooled result · Composite of postoperative pulmonary complicationsResult — go to the resultRelative risk 0.55 95% CI 0.38–0.78Authors' conclusion
Compared with fixed PEEP, individualized PEEP titration by lung compliance is associated with a reduced risk of postoperative pulmonary complications during OLV, especially in PEEP titration by dynamic compliance or stepwise decremental strategy.
Study context
- Population
- Patients undergoing one-lung ventilation (OLV)
- Participants
- 3,426 patients · 10 RCTs
- Comparison
- Individualized PEEP vs Fixed PEEP
- Outcome
- Composite of postoperative pulmonary complications
Methodological detailssubgroup analyses
- Subgroup analyses
Pooled result
As reported in the abstract
Relative risk
0.55
95% CI 0.38–0.78
Individualized PEEP vs Fixed PEEP
RR 0.55 (95% CI 0.38–0.78)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Pneumonia | 0.71 (0.52–0.96) | |
| Atelectasis | 0.63 (0.45–0.88) | |
| 0.512Relative risk (log scale) |
Primary outcome by titration method (subgroup)
- Association evident with titration by dynamic compliance rather than driving pressure/static compliance, and with stepwise decremental but not stepwise incremental strategy
Respiratory mechanics and gas exchange
- Higher dynamic compliance, PaO2, PaO2/FiO2 and lower driving pressure with individualized PEEP
- No difference in ARDS, mortality, peak pressure, plateau pressure, PaCO2
Safety
Cardiovascular complications and hemodynamics (heart rate, MAP)
- No difference between individualized and fixed PEEP
Original publication
Individualized PEEP titration by lung compliance during one-lung ventilation: a meta-analysis. Crit Care. Published 15 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →