Evidence map›Paper›PMID 38438222›Full record

Trial reportKorean journal of anesthesiology2024

Comparison of lung aeration loss in open abdominal oncologic surgeries after ventilation with electrical impedance tomography-guided PEEP versus conventional PEEP: a pilot feasibility study.

A R Karthik, Nishkarsh Gupta, Rakesh Garg, Sachidanand Jee Bharati, M D Ray, Vijay Hadda, Sourabh Pahuja, Seema Mishra, Sushma Bhatnagar, Vinod Kumar

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Korean journal of anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

A R KarthikDepartment of Anesthesiology, Cancer Institute (WIA), Adyar, Chennai, India.
Nishkarsh GuptaDepartment of Onco-Anesthesia and Palliative Medicine, Dr. B.R.A. Institute Rotary Cancer Hospital, AIIMS, Ansari Nagar, New Delhi, India.
Rakesh GargDepartment of Onco-Anesthesia and Palliative Medicine, Dr. B.R.A. Institute Rotary Cancer Hospital, AIIMS, Ansari Nagar, New Delhi, India.
Sachidanand Jee BharatiDepartment of Onco-Anesthesia and Palliative Medicine, Dr. B.R.A. Institute Rotary Cancer Hospital, AIIMS, Ansari Nagar, New Delhi, India.
M D RayDepartment of Surgical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, AIIMS, Ansari Nagar, New Delhi, India.
Vijay HaddaDepartment of Pulmonary, Critical Care and Sleep Medicine, AIIMS, Ansari Nagar, New Delhi, India.
Sourabh PahujaDepartment of Pulmonary Medicine, Amrita Hospital, Faridabad, India.
Seema MishraDepartment of Onco-Anesthesia and Palliative Medicine, Dr. B.R.A. Institute Rotary Cancer Hospital, AIIMS, Ansari Nagar, New Delhi, India.
Sushma BhatnagarDepartment of Onco-Anesthesia and Palliative Medicine, Dr. B.R.A. Institute Rotary Cancer Hospital, AIIMS, Ansari Nagar, New Delhi, India.
Vinod KumarDepartment of Anesthesiology, University of Minnesota Medical School, Minneapolis, MN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExisting literature lacks high-quality evidence regarding the ideal intraoperative positive end-expiratory pressure (PEEP) to minimize postoperative pulmonary complications (PPCs). We hypothesized that applying individualized PEEP derived from electrical impedance tomography would reduce the severity of postoperative lung aeration loss, deterioration in oxygenation, and PPC incidence.

methodsA pilot feasibility study was conducted on 36 patients who underwent open abdominal oncologic surgery. The patients were randomized to receive individualized PEEP or conventional PEEP at 4 cmH2O. The primary outcome was the impact of individualized PEEP on changes in the modified lung ultrasound score (MLUS) derived from preoperative and postoperative lung ultrasonography. A higher MLUS indicated greater lung aeration loss. The secondary outcomes were the PaO2/FiO2 ratio and PPC incidence.

resultsA significant increase in the postoperative MLUS (12.0 ± 3.6 vs 7.9 ± 2.1, P < 0.001) and a significant difference between the postoperative and preoperative MLUS values (7.0 ± 3.3 vs 3.0 ± 1.6, P < 0.001) were found in the conventional PEEP group, indicating increased lung aeration loss. In the conventional PEEP group, the intraoperative PaO2/FiO2 ratios were significantly lower but not the postoperative ratios. The PPC incidence was not significantly different between the groups. Post-hoc analysis showed the increase in lung aeration loss and deterioration of intraoperative oxygenation correlated with the deviation from the individualized PEEP.

conclusionsIndividualized PEEP appears to protect against lung aeration loss and intraoperative oxygenation deterioration. The advantage was greater in patients whose individualized PEEP deviated more from the conventional PEEP.

Indexed as

Electric ImpedanceFeasibility StudiesPositive-Pressure RespirationPostoperative ComplicationsTomographyAbdominal NeoplasmsAdultAgedFemaleHumansLungMaleMiddle AgedPilot ProjectsUltrasonographyElectric impedanceFeasibility studiesGeneral anesthesiaLaparotomyLung compliancePositive-pressure respirationPulmonary atelectasis

Identifiers

PMID38438222
PMCPMC11150122

What OpenQuestion holds

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Registered trials

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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.