Respiratory failure & ventilation
Individualized Positive End-expiratory Pressure on Postoperative Atelectasis in Patients with Obesity: A Randomized Controlled Clinical Trial
Primary resultResult — go to the resultIntergroup difference 3.7 % 95% CI 0.5–6.8%Authors' conclusion
Postoperative atelectasis was lower in patients undergoing laparoscopic bariatric surgery under dynamic compliance-guided PEEP versus PEEP of 8 cm H2O. Postoperative Pao2/Fio2 did not differ between the two groups.
Study context
- Population
- Patients with obesity undergoing laparoscopic bariatric surgery19 per group analysed
- Participants
- 40 patients
- Comparison
- Dynamic compliance-guided positive end-expiratory pressure (PEEP) vs PEEP of 8 cm H2O
- Primary endpoint
- Postoperative atelectasis on CT, expressed as percentage to total lung tissue volume
- Follow-up
- 60 to 90 min after extubation
Primary result
As reported in the abstract
Intergroup difference
3.7 %
95% CI 0.5–6.8%
P = 0.025
By group
PEEP of 8 cm H2O vs Dynamic compliance-guided PEEP
intergroup difference 3.7 % (95% CI 0.5–6.8%); P = 0.025
Secondary outcomes
mmHg
| Outcome | Dynamic compliance-guided PEEP | PEEP of 8 cm H2O | Group difference (95% CI) | P value | |
|---|---|---|---|---|---|
| PaO2/FiO2 · 1 h after pneumoperitoneum | 397 | 337 | 60 (9–111) | P = 0.017 | |
| PaO2/FiO2 · 30 min after extubation | 359 | 375 | −17 (−53 to 21) | P = 0.183 | |
| −100−50050100150Difference (linear scale) |
Median PEEP with highest dynamic compliance during titration (all 40 patients)
- Median PEEP with highest dynamic compliance, cm H2O (IQR 13 to 17; range 8 to 19)
- 15
Safety
| Outcome | Dynamic compliance-guided PEEP | PEEP of 8 cm H2O |
|---|---|---|
| PPCs | 4 of 20 | 4 of 20 |
Original publication
Individualized Positive End-expiratory Pressure on Postoperative Atelectasis in Patients with Obesity: A Randomized Controlled Clinical Trial. Anesthesiology. Published 13 July 2023. doi:10.
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