Respiratory mechanics and mechanical power during low vs. high positive end-expiratory pressure in obese surgical patients – A sub-study of the PROBESE randomized controlled trial

Scharffenberg, M; Mandelli, M; Bluth, T; Simonassi, F; Wittenstein, J; Teichmann, R; Birr, K; Kiss, T; Ball, L; Pelosi, P; Schultz, MJ; Gama de Abreu, M; Huhle, R; PROBESE-investigators; Protective Ventilation Network; Clinical Trials Network of the European Society of Anaesthesiology and Intensive Care

doi:10.1016/j.jclinane.2023.111242

Respiratory failure & ventilation

Respiratory mechanics and mechanical power during low vs. high positive end-expiratory pressure in obese surgical patients – A sub-study of the PROBESE randomized controlled trial

J Clin AnesthPublished 12 Oct 2023Secondary analysis of the PROBESE randomised trial

Read the original article ↗PubMed

Cite

Authors' conclusion

In this sub-cohort of PROBESE, intra-operative ventilation with high PEEP and RM reduced intra-tidal recruitment/de-recruitment as well as driving pressure, elastance, resistance, and mechanical power, as compared with low PEEP.

Study context

Population: Adult obese patients undergoing abdominal surgery, 2 European university hospitals24 analysed per group
Participants: 48 patients

Comparison: HighPEEP+recruitment manoeuvres (RM) vs LowPEEP
HighPEEP+RMn = 24
LowPEEPn = 24reference

Methodological detailsprospective, two-centre substudy, multicentre two-arm RCT

Prospective
Two-centre substudy
Multicentre two-arm RCT

Primary result

As reported in the abstract

%E2 · following induction

HighPEEP+RM

−3.1

mean · SD 7.2 · %

LowPEEP

−12.4

mean · SD 10.2 · %

P < 0.001

Further findings

Mechanical power

P < 0.001

HighPEEP+RMmean 5.0 J∙min-1SD 2.2

LowPEEPmean 10.4 J∙min-1SD 4.7

PEEP

P < 0.001

HighPEEP+RMmean 11.7 cmH2OSD 0.4

LowPEEPmean 3.7 cmH2OSD 0.6

Driving pressure

P < 0.001

HighPEEP+RMmean 12.8 cmH2OSD 3.5

LowPEEPmean 21.7 cmH2OSD 6.8

Tidal volume

P = 0.835

HighPEEP+RMmean 7.3 ml∙kg-1SD 0.6

LowPEEPmean 7.4 ml∙kg-1SD 0.8

Respiratory rate

P = 0.150

HighPEEP+RMmean 14.6 min-1SD 2.5

LowPEEPmean 15.7 min-1SD 2.0

Total resistance

P = 0.009

HighPEEP+RMmean 13.3 cmH2O∙l∙s-2SD 3.8

LowPEEPmean 17.7 cmH2O∙l∙s-2SD 6.8

Elastance

P < 0.001

HighPEEP+RMmean 15.7 cmH2O∙lSD 5.5

LowPEEPmean 28.5 cmH2O∙lSD 8.4

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Reference

Authors: Scharffenberg M, Mandelli M, Bluth T, Simonassi F, Wittenstein J, Teichmann R, et al.
All 16 authors
Scharffenberg M, Mandelli M, Bluth T, Simonassi F, Wittenstein J, Teichmann R, Birr K, Kiss T, Ball L, Pelosi P, Schultz MJ, Gama de Abreu M, Huhle R, PROBESE-investigators, Protective Ventilation Network, Clinical Trials Network of the European Society of Anaesthesiology and Intensive Care
Journal: Journal of Clinical Anesthesia
Published: 12 Oct 2023
DOI: 10.1016/j.jclinane.2023.111242
PubMed: 37833194
Registration: NCT02148692

Topic: Respiratory failure & ventilation

Comparison

Positive end-expiratory pressure (PEEP) 12 cmH2O with repeated recruitment manoeuvres vs PEEP 4 cmH2O without recruitment manoeuvres

Key notes

%E2 also higher in HighPEEP+RM at subsequent timepoints

Original publication

Respiratory mechanics and mechanical power during low vs. high positive end-expiratory pressure in obese surgical patients – A sub-study of the PROBESE randomized controlled trial. J Clin Anesth. Published 12 October 2023. doi:10.1016/j.jclinane.2023.111242

Read the original article ↗

Composed by AI from the published abstract and checked against it. How Briefs are made →