Respiratory failure & ventilation
Standardized low-flow ventilation with PEEP maintenance during bronchoscopy in mechanically ventilated ICU patients: a pilot trial
Authors' conclusion
This protocol implementation study demonstrates that standardized low-flow ventilation with PEEP maintenance is feasible and safe during bronchoscopy in mechanically ventilated patients, with a significant reduction in peak inspiratory pressure as a robust mechanical signal.
Study context
- Population
- Adults intubated and ventilated in volume-assist-control mode undergoing bronchoscopy in the ICU
- Participants
- 35 vs 36
- Comparison
- Intervention vs Observational
- Interventionn = 35
- Observationaln = 36reference
- Outcome
- Peak inspiratory pressure (PIP)
Methodological detailssingle-center, before-and-after design, 1-month training period before intervention phase, Physiologic and ventilator data automatically recorded at 1-min intervals
- Single-center
- Before-and-after design
- 1-month training period before intervention phase
- Physiologic and ventilator data automatically recorded at 1-min intervals
Main finding
As reported in the abstract
PIP
Peak inspiratory pressure (PIP) decreased substantially (median [IQR], intervention vs observational phase)
45 [35, 65] cmH2O vs. 82 [59, 93] cmH2O; p < 0.001
Secondary outcomes
Time spent with pressure alarms
- Reduced (intervention vs observational phase)
- 3.4% vs. 24%; p < 0.0001
Minute ventilation (MV)
- No significant difference (intervention vs observational phase)
- 5.2 [4.6, 5.9] L/min vs. 6.4 [4.1, 7.3] L/min; p = 0.2
End-tidal CO2 (EtCO2)
- No significant difference (intervention vs observational phase)
- 36 [30, 40] mmHg vs. 31 [27, 39] mmHg; p = 0.4
PEEP
- PEEP maintained in the intervention group (intervention vs observational phase)
- 8 [6, 10] cmH2O vs. 2 [0, 5] cmH2O; p = 0.001
Safety
Average SpO2
- No significant difference (intervention vs observational phase)
- 98.9 [93.7, 100.0]% vs. 99.9 [96.8, 100.0], p = 0.082
Hypotension incidence
- No significant difference (intervention vs observational phase)
- 8.6% vs. 14%; p = 0.7
Original publication
Standardized low-flow ventilation with PEEP maintenance during bronchoscopy in mechanically ventilated ICU patients: a pilot trial. J Intensive Care. Published 21 June 2026. doi:10.
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