Observational studyAnnals of surgery2016
Differential Effects of Intraoperative Positive End-expiratory Pressure (PEEP) on Respiratory Outcome in Major Abdominal Surgery Versus Craniotomy.
Observational study in Annals of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Intraoperative Fentanyl Dose on Postoperative Respiratory Complications
An Anesthesia-Centered Bundle to Reduce Postoperative Pulmonary Complications: The PRIME-AIR Study
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- Efficacy and safety of lung-protective ventilation in neurosurgery: a systematic review and meta-analysis of randomized controlled clinical trials.Frontiers in medicine · 2026Pooled it
- Pooled it
- Effect of different lung recruitment maneuvers on postoperative respiratory outcomes and lung aeration, assessed by lung ultrasound, in patients undergoing thoracoscopic sympathectomy: a randomized controlled trial.BMC anesthesiology · 2026Trial
- Effect of driving pressure on early postoperative lung gas distribution in supratentorial craniotomy: a randomized controlled trial.BMC anesthesiology · 2023Trial
- The efficacy of different alveolar recruitment maneuvers in holmium laser lithotripsy surgery under general anesthesia using a laryngeal mask.BMC anesthesiology · 2022Trial
- Individualized PEEP to optimise respiratory mechanics during abdominal surgery: a pilot randomised controlled trial.British journal of anaesthesia · 2020Trial
- Low tidal volume ventilation with low PEEP during surgery may induce lung inflammation.BMC anesthesiology · 2016Trial
- "Tailored" vs. "one-size-fits-all": current knowledge of individualized PEEP and constant PEEP strategy during the perioperative period.European journal of medical research · 2025Review
- ARISCAT and LAS VEGAS risk scores for predicting postoperative pulmonary complications after cardiac surgery: a cohort study.Annals of medicine and surgery (2012) · 2024Article
- Article
- An anesthesia-centered bundle to reduce postoperative pulmonary complications: The PRIME-AIR study protocol.PloS one · 2023Article
- A structured narrative review of clinical and experimental studies of the use of different positive end-expiratory pressure levels during thoracic surgery.The clinical respiratory journal · 2022Review
- Recruitment Maneuver to Reduce Postoperative Pulmonary Complications after Laparoscopic Abdominal Surgery: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2022Review
- Intraoperative Protective Mechanical Ventilation: Fact or Fiction?Anesthesiology · 2022Article
- Geo-economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia- posthoc analysis of an observational study in 29 countries.BMC anesthesiology · 2022Observational
- Perioperative Pulmonary Atelectasis: Part II. Clinical Implications.Anesthesiology · 2022Review
- Translational Role of Rodent Models to Study Ventilator-Induced Lung Injury.Translational perioperative and pain medicine · 2021Article
- The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.BMC anesthesiology · 2021Observational
- Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study.BMC anesthesiology · 2020Observational
- Recent advances in understanding and managing postoperative respiratory problems.F1000Research · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 7 institutions in 4 countries.
Funding
Abstract
objectivesIn this study, we examined whether (1) positive end-expiratory pressure (PEEP) has a protective effect on the risk of major postoperative respiratory complications in a cohort of patients undergoing major abdominal surgeries and craniotomies, and (2) the effect of PEEP is differed by surgery type.
backgroundProtective mechanical ventilation with lower tidal volumes and PEEP reduces compounded postoperative complications after abdominal surgery. However, data regarding the use of intraoperative PEEP is conflicting.
methodsIn this observational study, we included 5915 major abdominal surgery patients and 5063 craniotomy patients. Analysis was performed using multivariable logistic regression. The primary outcome was a composite of major postoperative respiratory complications (respiratory failure, reintubation, pulmonary edema, and pneumonia) within 3 days of surgery.
resultsWithin the entire study population (major abdominal surgeries and craniotomies), we found an association between application of PEEP ≥5 cmH2O and a decreased risk of postoperative respiratory complications compared with PEEP <5 cmH2O. Application of PEEP >5 cmH2O was associated with a significant lower odds of respiratory complications in patients undergoing major abdominal surgery (odds ratio 0.53, 95% confidence interval 0.39 - 0.72), effects that translated to deceased hospital length of stay [median hospital length of stay : 6 days (4-9 days), incidence rate ratios for each additional day: 0.91 (0.84 - 0.98)], whereas PEEP >5 cmH2O was not significantly associated with reduced odds of respiratory complications or hospital length of stay in patients undergoing craniotomy.
conclusionsThe protective effects of PEEP are procedure specific with meaningful effects observed in patients undergoing major abdominal surgery. Our data suggest that default mechanical ventilator settings should include PEEP of 5-10 cmH2O during major abdominal surgery.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.