Perioperative medicine & outcomes
Intra‐operative ventilation strategies and their impact on clinical outcomes: a systematic review and network meta‐analysis of randomised trials
Authors' conclusion
Among patients undergoing non-cardiothoracic surgery, the use of intra-operative low tidal volume ventilation with a range of acceptable PEEP levels likely reduced the risk of postoperative pulmonary complications compared with high tidal volumes and zero PEEP.
Study context
- Population
- Adults having non-cardiothoracic surgery, followed up > 24 hours postoperatively51 RCTs
- Comparison
- Intra-operative ventilation strategies vs high tidal volume/zero positive end-expiratory pressure (PEEP)
- Outcome
- Incidence of PPCs
Pooled result
As reported in the abstract
PPCs
Relative risk (95% CI)
Low tidal volume/high PEEP vs High tidal volume/zero PEEP
0.44(0.22–0.87)
Low tidal volume/high PEEP with recruitment manoeuvres vs High tidal volume/zero PEEP
0.60(0.49–0.75)
Low tidal volume/personalised PEEP with recruitment manoeuvres vs High tidal volume/zero PEEP
0.53(0.42–0.69)
Low tidal volume/low PEEP vs High tidal volume/zero PEEP
0.63(0.50–0.78)
Low tidal volume/low PEEP with recruitment manoeuvres vs High tidal volume/zero PEEP
0.65(0.46–0.93)
Low tidal volume/personalised PEEP vs Low tidal volume/low PEEP
0.85(0.73–0.99)
Original publication
Intra‐operative ventilation strategies and their impact on clinical outcomes: a systematic review and network meta‐analysis of randomised trials. Anaesthesia. Published 25 March 2025. doi:10.
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