Individualized positive end-expiratory pressure guided by respiratory mechanics during anesthesia for the prevention of postoperative pulmonary complications: a systematic review and meta-analysis
Pooled resultResult — go to the resultRelative risk 0.54 95% CI 0.42–0.69Authors' conclusion
The PEEP titration method based on respiratory mechanics seems to work positively for lung protection in surgical patients undergoing general anesthesia.
Study context
- Population
- Adults undergoing surgery under GA
- Participants
- 1,105 adults · 14 randomized controlled trials (RCTs)
- Comparison
- Individualized positive end-expiratory pressure (PEEP) guided by respiratory mechanics vs constant PEEP
- Outcome
- PPCs
Methodological detailsSearched PubMed, Embase and Cochrane Library
- Searched PubMed, Embase and Cochrane Library
Pooled result
As reported in the abstract
Relative risk
0.54
95% CI 0.42–0.69
Individualized PEEP vs Constant PEEP
RR 0.54 (95% CI 0.42–0.69)
Further pooled results
Common postoperative pulmonary complications (PPCs) (pulmonary infections, hypoxemia, atelectasis, pleural effusion)
- Pulmonary infections, hypoxemia and atelectasis favoured individualized PEEP; pleural effusion did not
Intraoperative respiratory mechanics (driving pressure, Crs) and oxygenation
- Improved with PEEP based on respiratory mechanics
Original publication
Individualized positive end-expiratory pressure guided by respiratory mechanics during anesthesia for the prevention of postoperative pulmonary complications: a systematic review and meta-analysis. J Clin Monit Comput. Published 6 January 2023. doi:10.
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