Respiratory failure & ventilation
Individualized positive end-expiratory pressure (PEEP) titration guided by static lung compliance reduces postoperative atelectasis in elderly patients during laparoscopic Trendelenburg surgery: a randomized controlled trial
Authors' conclusion
For elderly patients undergoing laparoscopic rectal cancer surgery in the Trendelenburg position, individualized PEEP titration based on static lung compliance is associated with lower postoperative lung ultrasound scores (primarily located in the lateral and posterior zones) and may potentially alleviate atelectasis.
Study context
- Population
- Elderly patients aged 65–75 years, ASA II–III, BMI 19–28 kg/m², scheduled for elective laparoscopic rectal cancer surgery in Trendelenburg position, anticipated duration > 2 h
- Participants
- 70 patients
- Comparison
- Individualized PEEP guided by static lung compliance vs fixed PEEP
Primary result
As reported in the abstract
Lung ultrasound scores (LUS)
CV vs DVMean difference (95% CI)
Immediately post-surgery (T4)
−4.0(−7.0 to −2.0)
Before PACU discharge (T5)
−4.06(−6.3 to −1.7)
Further findings
| Outcome | Median difference (95% CI) | |
|---|---|---|
| Serum SP-A · T5 | 33.39 (15.90–47.44) | |
| −200204060Difference (linear scale) |
- Serum SP-A: all p < 0.05
Dynamic and static compliance, driving pressure · T3 and T4
- Increased dynamic and static compliance with decreased driving pressure in CV vs DV (all p < 0.05)
VD/VT, PaO2/FiO2 ratio, invasive arterial pressure
- No significant differences
Original publication
Individualized PEEP titration guided by static lung compliance reduces postoperative atelectasis in elderly patients during laparoscopic Trendelenburg surgery: a randomized controlled trial. Perioper Med (Lond). Published 19 June 2026. doi:10.
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