Perioperative medicine & outcomes
Safety and feasibility of intraoperative high positive end-expiratory pressure (PEEP) titrated to the lowest driving pressure during anesthesia for minimally invasive abdominal surgery – Interim analysis of GENERATOR
Primary result · Intraoperative hypotensionResult — go to the resultRelative risk ratio 1.0 95 % CI 0.5–2.4Authors' conclusion
In minimally invasive abdominal surgery, a ventilation strategy using individualized high PEEP was not associated with a higher incidence of hypotension, but did show an increased use of vasopressors. The intervention was highly feasible, and led to a lower ΔP.
Study context
- Population
- Patients undergoing minimally invasive abdominal surgery under GA177 analysed
- Participants
- 181 patients
- Comparison
- Individualized high PEEP titrated to the lowest ΔP vs standard low PEEP
- Individualized high PEEPn = 87
- Standard low PEEPn = 90reference
- Primary endpoint
- Proportion of patients with intraoperative hypotension
Methodological detailsongoing
- Ongoing
Primary result
Intraoperative hypotension
Relative risk ratio
1.0
95 % CI 0.5–2.4
P = 1.00
By group
Individualized high PEEP vs Standard low PEEP
relative risk ratio 1.0 (95 % CI 0.5–2.4); P = 1.00
As reported in the abstract
Secondary outcomes
Protocol compliance
| Outcome | Median difference (cm H2O) |
|---|---|
| Driving pressure (ΔP) | 6 |
- Protocol compliance: most non-compliance in high PEEP group concerned PEEP too high
Safety
- Vasopressor use higher in the intervention group
Original publication
Safety and feasibility of intraoperative high PEEP titrated to the lowest driving pressure during anesthesia for minimally invasive abdominal surgery – Interim analysis of GENERATOR. J Clin Anesth. Published 30 September 2025. doi:10.
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