Background: Higher positive end-expiratory pressure (PEEP) during laparoscopic surgery may increase oxygenation and respiratory compliance. This meta-analysis aimed to compare the impact of different intraoperative PEEP strategies on arterial oxygenation, compliance, and hemodynamics during laparoscopic surgery in non-obese patients.
Methods: We searched RCTs in PubMed, Cochrane Library, Web of Science, and Google Scholar from January 2012 to April 2022 comparing the different intraoperative PEEP (Low PEEP (LPEEP): 0-4 mbar; Moderate PEEP (MPEEP): 5-8 mbar; high PEEP (HPEEP): >8 mbar; individualized PEEP - iPEEP) on arterial oxygenation, respiratory compliance (Cdyn), mean arterial pressure (MAP), and heart rate (HR). We calculated mean differences (MD) with 95% confidence intervals (CI), and predictive intervals (PI) using random-effects models. The Cochrane Bias Risk Assessment Tool was applied.
Results: 21 RCTs (n = 1554) met the inclusion criteria. HPEEP vs. LPEEP increased PaO (+ 29.38 [16.20; 42.56] mmHg, p < 0.0001) or PaO/FiO (+ 36.7 [+ 2.23; +71.70] mmHg, p = 0.04). HPEEP vs. MPEEP increased PaO (+ 22.00 [+ 1.11; +42.88] mmHg, p = 0.04) or PaO/FiO (+ 42.7 [+ 2.74; +82.67] mmHg, p = 0.04). iPEEP vs. MPEEP increased PaO/FiO (+ 115.2 [+ 87.21; +143.20] mmHg, p < 0.001). MPEEP vs. LPEP, and HPEEP vs. MPEEP increased PaO or PaO/FiO significantly with different heterogeneity. HPEEP vs. LPEEP increased Cdyn (+ 7.87 [+ 1.49; +14.25] ml/mbar, p = 0.02). MPEEP vs. LPEEP, and HPEEP vs. MPEEP did not impact Cdyn (p = 0.14 and 0.38, respectively). iPEEP vs. LPEEP decreased driving pressure (-4.13 [-2.63; -5.63] mbar, p < 0.001). No significant differences in MAP or HR were found between any subgroups.
Conclusion: HPEEP and iPEEP during PNP in non-obese patients could promote oxygenation and increase Cdyn without clinically significant changes in MAP and HR. MPEEP could be insufficient to increase respiratory compliance and improve oxygenation. LPEEP may lead to decreased respiratory compliance and worsened oxygenation.
Prospero Registration: CRD42022362379; registered October 09, 2022.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638810 | PMC |
| http://dx.doi.org/10.1186/s12871-023-02337-0 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effect of Aerobic Exercises on Lung Function in Women With Fibromyalgia: A Randomized Controlled Trial.
J Phys Act Health
January 2025
Department of Physiotherapy, Faculty of Allied Medical Sciences, Middle East University, Amman, Jordan.
Background: Aerobic exercises (AEs) have gained much interest in managing fibromyalgia (FM). This trial aimed to find out how AEs affect women with FM in terms of lung function, chest expansion, dyspnea, exercise capacity, and quality of life.
Methods: Eighty FM-diagnosed women were allocated randomly into 2 equal-sized groups.
Introduction: A recent scoping review identified histological chorioamnionitis (HCA), small for gestational age (SGA), and bubbly/cystic appearance on chest X-ray (bubbly/cystic CXR) as risk factors for severe bronchopulmonary dysplasia (BPD). To further validate these results, a large-scale database was analyzed.
Methods: This retrospective multicenter cohort study included infants born at <28 weeks' gestational age between 2003 and 2016.
How FocA facilitates fermentation and respiration of formate by .
J Bacteriol
January 2025
Institute for Microbiology, Martin Luther University Halle-Wittenberg, Halle (Saale), Saxony-Anhalt, Germany.
Formic acid is an important source of reductant and energy for many microorganisms. Formate is also produced as a fermentation product, e.g.
View Article and Find Full Text PDFErector Spinae Muscle to Epicardial Visceral Fat Ratio on Chest CT Predicts the Severity of Coronavirus Disease 2019.
J Cachexia Sarcopenia Muscle
February 2025
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Background: Chest computed tomography (CT) is a valuable tool for diagnosing and predicting the severity of coronavirus disease 2019 (COVID-19) and assessing extrapulmonary organs. Reduced muscle mass and visceral fat accumulation are important features of a body composition phenotype in which obesity and muscle loss coexist, but their relationship with COVID-19 outcomes remains unclear. In this study, we aimed to investigate the association between the erector spinae muscle (ESM) to epicardial adipose tissue (EAT) ratio (ESM/EAT) on chest CT and disease severity in patients with COVID-19.
View Article and Find Full Text PDFImpact of Cannulation Strategy and Extracorporeal Blood Flow on Recirculation During Veno-Venous Extracorporeal Membrane Oxygenation.
Artif Organs
January 2025
Department of Cardiovascular Surgery, Faculty of Medicine, University Medical Centre Freiburg, University of Freiburg, Freiburg, Germany.
Introduction: Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is increasingly used in the treatment of severe respiratory failure. Despite a significant increase in the worldwide use of extracorporeal lung assist devices recirculation remains a common complication and is associated with a reduced effectiveness of ECMO support and increased hemolysis. In this observational study we aimed to investigate the impact of cannula configuration and extracorporeal flow on recirculation.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!