Preoxygenation algorithm: sequential pressure support ventilation (PSV) and positive end-expiratory pressure (PEEP) versus tidal volume breathing. a randomized controlled trial
Authors' conclusion
An algorithmic approach, stepwise adding PSV and PEEP in patients inadequately preoxygenated with standard TVB, may improve adequate preoxygenation in all patients and reduces the time required.
Study context
- Population
- Patients planned for GA with end-tidal oxygen (ETO2) < 90% after 3 min tidal volume breathing (TVB)
- Participants
- 200 patients
- Comparison
- Stepwise PSV then PSV plus PEEP vs continued TVB for preoxygenation
- Primary endpoint
- Time required to achieve ETO2 ≥ 90%
Methodological detailssequential randomisation
- Sequential randomisation
Primary result
As reported in the abstract
Total time to ETO2 ≥ 90%
P = 0.003
Further findings
Duration of adequate preoxygenation between 4 and 5 min — TVB vs PSV-PEEP
P < 0.001
| Outcome | TVB | PSV | PSV-PEEP | P value |
|---|---|---|---|---|
| Adequate preoxygenation · 4 minPSV vs TVB | 52% | 76% | — not stated in the abstract | P < 0.001 |
| Adequate preoxygenation · 5 min | 100% | 97% | — not stated in the abstract | |
| Duration of adequate preoxygenation between 4 and 5 minPSV vs PSV-PEEP | P = 0.001 |
— not stated in the abstract
Safety
- No serious adverse effects observed
Original publication
Preoxygenation algorithm: sequential PSV and PEEP versus tidal volume breathing. a randomized controlled trial. Perioper Med (Lond). Published 15 October 2025. doi:10.
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