Respiratory failure & ventilation
Short-term Modification of Postoperative Ventilation Phenotypes With Electrical Impedance Tomography-guided Positive End-expiratory Pressure Titration
Authors' conclusion
Short-term modification of postoperative ventilation phenotypes is feasible with EIT-guided phenotype-directed PEEP titration.
Study context
- Population
- Mechanically ventilated adults admitted to the ICU after surgery at high risk of postoperative pulmonary complications (PPCs)30 received PEEP titration
- Participants
- 60 participants
- Comparison
- Electrical impedance tomography (EIT)-guided individualized PEEP titration in heterogeneous ventilation vs no protocolized intervention in homogeneous ventilation
- Phenotype 1n = 15
- Phenotype 3n = 15
- Homogeneous ventilationn = 30reference
- Primary endpoint
- Feasibility of achieving homogenization
Methodological detailssingle-centre, non-randomized, August 2024 to June 2025
- Single-centre
- Non-randomized
- August 2024 to June 2025
Primary result
As reported in the abstract
Immediate phenotype conversion (homogenization) · Immediate
Immediate phenotype conversion achieved in 29 of 30
96.7%
96.7%; 95% CI, 82.8–99.9%
Further findings
| Outcome | Interventional cohort | Historical cohort | Absolute risk difference (%) (95% CI) | P value | |
|---|---|---|---|---|---|
| Severe PPCs (exploratory comparison with historical cohort)Exploratory comparison | 25% | 41% | −15.8 (−38.8 to 2.2) | P = 0.17 | |
| −40−20020Difference, % (linear scale) |
Remained within target dorsal fraction of ventilation (DFV) range · 4 h
- 28 of 30 remained within target DFV range
- 93.3% (93.3%; 95% CI, 77.9-99.2%)
Ventral-dominant patterns (subgroup): PEEP, respiratory system compliance, PaO2/FiO2
- Respiratory system compliance increased by 9.2 mL/cm H₂O
- 9.2 (95% CI, 6.1-12.3)
- PaO2/FiO2 increased by 61.9 mm Hg
- 61.9 (95% CI, 8.6-115.2)
- PEEP increased from 5 to 9 cm H₂O
- n=15
Dorsal-dominant patterns (subgroup): PEEP, ventral compliance
- Ventral compliance increased by 3.4 mL/cm H₂O
- 3.4 (95% CI, 1.1-5.8)
- PEEP decreased from 7 to 3 cm H₂O
- No changes in global respiratory system compliance or oxygenation
- n=15
Haemodynamics
- Individualized PEEP reduced mean pulmonary artery pressure and increased cardiac index
Original publication
Short-term Modification of Postoperative Ventilation Phenotypes With Electrical Impedance Tomography-guided Positive End-expiratory Pressure Titration. Anesthesiology. Published 17 September 2026. doi:10.
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